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Cancer Screening Harms Quantified in Recent Trials

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Lauren Lopez4 years ago

While the benefits of cancer screening are well-known, what get overlooked, accodrding to a Medscape report, are the negative impacts that they can have as well. The adverse effects related to cancer screenings include somatic, or bodily, and psychological. These harms are the result of the screening test itself, through false positive findings and exaggerated diagnosis resulting in overtreatment.  Because there is a high level of risk for healthy individuals, cancer screening should be administered only when the benefits outweigh the possible negative impacts.

In order to determine the benefits of screenings, randomized clinical trials should be conducted and assessed, to ensure the quality of the benefits.  However, the negative impacts of cancer screening remain poor and under reported.  Evidence suggests that reporting of harms is worse in non-pharmacological trials than in trials assessing drugs.

Negative Effects of Cancer Screenings

The negative side effects of screening found in the 57 clinical trials included:

• Overdiagnosis (7%)
• False-positive findings (4%)
• Somatic complications (19%)
• Negative psychosocial consequences (9%)
• Invasive procedures (47%)
• All-cause mortality (60%)
• Withdrawal because of adverse events (2%)

Results of the Cancer Screening Clinical Trials

According to the British Medical Journal, the findings of several clinical trials included:

• Out of 4590 articles assessed, 198 (57 trials, 10 screening technologies) matched the inclusion criteria.
• False positive findings were quantified in two of 57 trials (4%, 95% confidence interval 0% to 12%)
• Overdiagnosis in four (7%, 2% to 18%)
• Negative psychosocial consequences in five (9%, 3% to 20%)
• Somatic complications in 11 (19%, 10% to 32%)
• Use of invasive follow-up procedures in 27 (47%, 34% to 61%), all cause mortality in 34 (60%, 46% to 72%)
• Withdrawals because of adverse effects in one trial (2%, 0% to 11%).
• The median percentage of space in the results section that reported harms was 12% (interquartile range 2-19%).

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