nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Wednesday, March 2, 2011

CIty Funds Brain Cancer Scans For The Healthy

Unnecessary screening leads to unnecessary treatment.

I ran across this article in the Wall Street Journal Health blog (Mar 2): 

"NYC City Council Funds Unproven Cancer-Screening Program"

Apparently the city funds a scanner to the tune of about $2 million to go around the city scanning normal people for brain cancer.

The article rightly points out that there are situations where screening is at least prudent (both your parents are diabetic, and you get a fasting blood sugar).  But this is one of those situations where it's not.

Brain cancer is very uncommon.  I'm not sure how many people you have to screen to find a "real" brain cancer, but I bet it's in the thousands.  From that same population you will find hundreds with other "findings" that may suggest they need to be treated, but more likely you're better off without treating...and without knowing.

The prostate cancer blood test, prostate specific antigen (PSA), is a case in point:
"The PSA test, the benefits of which still aren’t clear, has become the poster child for this controversy. (One analysis found that for every life saved by the PSA, 47 men received unnecessary treatment and risked side effects like incontinence.)"
Epidemiologic data, the sensitivity and specificity of the screening test, and (most importantly) the risk factors of the patient,  need to be guiding factors in screening for medical diagnoses.

There's an old saying among doctors, "Test enough and you'll find something."

That's not preventive health care, it's fishing.

Doc D

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