NLM Director’s Comments Transcript
Cancer Screening Overview: 03/25/2013

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Greetings from the National Library of Medicine and MedlinePlus.gov
Regards to all our listeners!
I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
Here is what's new this week in MedlinePlus.

A guide to cancer screening, recently published in Consumer Reports, suggests some common tests have more risks than benefits for many adults.
The well-researched article, from the magazine’s internal investigative reporting team called ‘CR investigates,’ suggests some cancer screening is oversold. The report finds (and we quote): ‘too many people are getting tests they don’t need or understand, and too few are getting those that could save their lives’ (end of quote).
The authors note patients and health care providers find it challenging to assess and understand the risks versus the benefits of some cancer screening tests. While the authors acknowledge early detection can save lives, the article adds there are common risks from some cancer screenings. These include:

Tthe inability of some cancer tests to detect between harmless forms of cancer (that sometimes disappear on their own) and lethal cancer
The misapplication of population-wide cancer risk statistics to some individual cases
Tthe inability of some cancer screening tests to pinpoint if the disease’s progression is at a stage where a successful medical intervention is likely to occur.

The authors also urge patients to ask a health care provider to take the time to compare a cancer screening’s risks and benefits.
Within the latter conversation, the authors suggest patients ask the following questions (that we provide verbatim):

If the test results are positive, will it save my life?
Am I at higher risk for cancer than the average person, and if so, why?
How often does the test give false alarms? How often does it provide falsely reassuring results?
Are any other tests just as good?
If the results are positive, what’s next?

More specifically, the article highly recommends the following groups of patients obtain these cancer screenings:

Cervical cancer screenings for women ages 21-65.
Breast cancer screenings for women ages 50-74.
Colon cancer screenings for adults ages 50-75.

However, the article does not recommend the aforementioned screenings for patients at different ages because for other age groups the test’s risks may outweigh its benefits.
More importantly, the article suggests most adults avoid several cancer screenings, such as bladder cancer, lung cancer, oral cancer, skin cancer, and pancreatic cancer -- when a person is not at a high risk for these diseases. If a person is at high cancer risk because of factors such as prior disease, environmental conditions, or family medical history, Consumer Reports recommends these patients obtain screening.
Similarly, Consumer Reports suggests men without high risk avoid testicular cancer and prostate cancer screenings, while men at high risk should be tested. Consumer Reports suggests women without high risk should avoid ovarian cancer screenings while women at high risk should be tested.
Meanwhile, MedlinePlus.gov’s health screening health topic page provides a comprehensive resource of screening information. For example, there is a helpful introduction to cancer and other health screenings (from the U.S. Department of Health and Human Service’s Office of Disease Prevention and Health Promotion) within the ‘overviews’ section.
The National Cancer Institute also provides very specific information about cancer screenings – called ‘Cancer Information Summaries’ – within the ‘specific conditions’ section of MedlinePlus.gov’s health screening health topic page. The latter website provides expert information about diverse, common cancer screening tests.
MedlinePlus.gov’s health screening health topic page additionally contains links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. From the health screening health topic page, you can sign up to receive email updates with links to new information as it becomes available on MedlinePlus.
To find MedlinePlus.gov’s health screening health topic page, just type ‘health screening’ in the search box at the top of MedlinePlus.gov’s home page. Then, click on ‘health screening (National Library of Medicine).’ MedlinePlus also contains other related health topic pages, including healthy checkup and laboratory tests.
We appreciate Consumer Reports efforts to clarify some of the confusion surrounding cancer screening information. As the article suggests, a key issue for patients is to remember all cancer screenings contain risks as well as benefits. If nothing else is accomplished, the Consumer Reports article serves as a catalyst to discuss cancer screening issues with your physician.
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