"Test here. Test now. Test, baby, test!" has become the conventional wisdom for handling the COVID-19 pandemic. But false positives and false negatives create substantial problems for mass testing.
screening
This phrase sound so lyrical, but it refers to the subsequent care and actions of patients and physicians after some initial test. For low-value testing, it results in unwarranted worry and costs.
Screening tests for colorectal cancer are generally underutilized, and thus chances to decrease deaths from the disease are missed. New research demonstrates that an app, which patients can use on an iPad, increases the use of these screening tests.
We would think a physician could use guidelines to advise a patient about screening. But what if the guidelines are good for society, but not necessarily as good for the patient? Three separate articles in the Annals of Internal Medicine clarify the dilemma, without providing a solution.
Time for a colonoscopy? Many want to shun this screening for colorectal cancer, but according to the US Preventive Services Task Force, having the procedure is the best way to go. This and other modalities were evaluated in their latest recommendations on CRC screening.
Colonoscopies have been hailed as the hero for the decreasing the incidence and death from colon cancer. An essay, published in the New England Journal of Medicine, claims that other factors, not just colonoscopy screenings, are contributing to the decline.
The Canadian Task Force on Preventive Health recently published its new recommendations in CMAJ, coming out against the use of colonoscopies for colorectal cancer screening in low-risk individuals.
A new advisory report from the U.S. Preventive Services Task Force recommends screening all adults for depression, now to include pregnant women and those who recently gave birth. Drug therapy, talk therapy and behavioral therapies were recommended when appropriate.
Screening for cancer may well reduce deaths from the cancer screened for but still not reduce (or even increase) overall mortality. That's the message in a recent BMJ meta-analysis of the harms and benefits of screening.
An op-ed in the NY Times co-authored by Dr. H. Gilbert Welch decries Medicare's proposal to penalize doctors for ordering the prostate screening tests. That seems like an odd sentiment to endorse, given that we here at the American Council believe that these tests are being given far too often.
Ovarian cancer is the leading cause of death in the U.S. from a gynecological malignancy. A recent study of the disease, the third and largest randomized, controlled trial ever with up to a 15-year follow-up, shows that screening for this type of cancer improves mortality rates by an estimated 20 percent.
A recent Huffington Post op-ed by a female MD demanded "the truth" about mammograms, so that women could best help themselves. Well, there's no truth yet: the data continue to be evaluated and medical societies continue to make the best guesses they can. So, women should learn what they can and discuss the options with their physician.