National survey finds U.S. public enthusiastic about cancer screening

HANOVER, NH - The public is committed to cancer screening, even with false-positive results or the possibility that testing could lead to unnecessary treatment, according to a Dartmouth Medical School (DMS) study in the January 7 issue of The Journal of the American Medical Association (JAMA). Such enthusiasm could put the public at risk for "overtesting and overtreatment" of certain cancers, warn the researchers.

"There is growing recognition among medical professionals that cancer screening is a double-edged sword," write the investigators who include Drs. Lisa M. Schwartz and Steven Woloshin, associate professors of medicine at DMS and Dr. Gilbert Welch, professor of medicine at DMS, all of whom are physicians based at the VA Medical Center in White River Junction, VT. "While some individuals may benefit from early detection, others may only be diagnosed and treated for cancer unnecessarily. The public needs access to balanced information about its [cancer screening] potential benefits and harms."

The researchers, led by Schwartz and Woloshin, conducted national telephone interviews with 500 adults during 2001 and 2002 to learn about experience with a broad range of screening tests. The survey included 360 women aged 40 years or older and 140 men aged 50 years or older without a history of cancer. It encompassed questions about the value of early detection; and four cancer screening tests: Papanicolaou (Pap); mammography; prostate-specific antigen (PSA); and sigmoidoscopy or colonoscopy.

"Most American adults (87 percent) feel routine cancer screening is almost always a good idea," the investigators found. "Seventy-four percent believe that finding cancer early saves lives 'most' or 'all of the time.' Fifty-three percent believe screening usually reduces the amount of treatment needed when cancer is found."

The authors, who include members of the VA Outcomes Group and the Norris Cotton Cancer Center at Dartmouth, r

Contact: Andy Nordhoff
Dartmouth Medical School

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