Except possibly for colorectal cancer screening with sigmoidoscopy, common cancer screening tests do not extend life, according to a new study published in JAMA Internal Medicine.
The study, which was a systematic review and meta-analysis of 18 long-term randomized clinical trials involving 2.1 million individuals, found that colorectal cancer screening with sigmoidoscopy prolonged lifetime by 110 days, while fecal testing and mammography screening did not prolong life. An extension of 37 days was noted for prostate cancer screening with prostate-specific antigen testing and 107 days with lung cancer screening using CT. The study involved more than 1 decade of follow-up reporting all-cause mortality of people who had undergone mammography screening for breast cancer; colonoscopy, sigmoidoscopy, or fecal occult blood testing for colorectal cancer; CT screening for lung cancer in smokers and former smokers; or prostate-specific antigen testing for prostate cancer.
AGA
Dr. Lawrence Kim
The study received a fair amount of attention in the press, but
“Cancer prevention and earlier stage diagnoses through colorectal cancer screening provides significant morbidity and cost benefits, even if all-cause mortality is not reduced,” said Lawrence Kim, MD, AGAF, AGA vice president.
The authors of the study, who were led by Michael Bretthauer, MD, PhD, of the Clinical Effectiveness Research Group, University of Oslo, are not suggesting that cancer screenings be abandoned. However, they do suggest that “organizations, institutions, and policy makers who promote cancer screening tests by their effect to save lives may find other ways of encouraging screening. It might be wise to reconsider priorities and dispassionately inform interested people about the absolute benefits, harms, and burden of screening tests that they consider undertaking.”
