Cancer – are we building an industry instead of helping patients?
Cancer is costing more than ever – for patients, health systems and whole countries – but is the growing cancer “industry” making life better for patients, or even improving their chances of survival?
According to John Horgan, writing in the latest issue of Scientific American, the enormous amounts of money spent on research and treatment have resulted in little benefit for patients overall, and in many cases actually make things worse. In spite of the billions of dollars spent each year, Horgan argues that deaths from cancer have barely changed since the early 1990s. The reduction in cancer deaths in recent decades followed many decades of increases, and the totals can be explained by the rise and fall in the rates of tobacco smoking – take smoking out of the picture and cancer mortality has barely changed. Horgan argues that the rise of widespread screening for cancers such as breast and prostate cancer have led to widespread overdiagnosis, leading in turn to unnecessary chemotherapy, radiotherapy and surgery. He points to a 2013 study that concluded: if 2,000 women have mammograms over a period of 10 years, one woman’s life will be saved by a positive diagnosis. Meanwhile 10 healthy women will be treated unnecessarily, and more than 200 “will experience important psychological distress including anxiety and uncertainty for years because of false positive findings.” Increasingly, the evidence shows that universal screening is actually doing more harm than good, potentially cutting short more lives than they extend. While studies of tests for a specific cancer often look at deaths caused by that cancer, tests such as mammograms may show a reduction in deaths from breast cancer. Crucially, they do not show deaths from other causes resulting directly or indirectly from the diagnosis and treatment – heart disease, infections, other forms of cancer and suicide. Horgan covers a lot more ground in his article, with references to various studies. We recommend reading it in full, as it is a complex subject. Click here to read the article.