Results for: overtreatment
The mammography wars heat up again
PRELUDE: THE PROBLEM WITH SCREENING If there’s one aspect of science-based medicine (SBM) that makes it hard, particularly for practitioners, it’s SBM’s continual requirement that we adjust what we do based on new information from science and clinical trials. It’s not easy for patients, either. To lay people, SBM’s greatest strength, its continual improvement and evolution as new evidence becomes available, can...
Another wrinkle to the USPSTF mammogram guidelines kerfuffle: What about African-American women?
A while back I wrote about rethinking how we screen for breast cancer using mammography. Basically, the USPSTF, an independent panel of physicians and health experts that makes nonbinding recommendations for the government on various health issues, reevaluated the evidence for routine screening mammography and concluded that for women at normal risk for breast cancer, mammography before age 50 should not be...
The USPSTF recommendations for breast cancer screening: Not the final word
Preface: On issues such as this, I think it’s always good for me to emphasize my disclaimer, in particular: Dr. Gorski must emphasize that the opinions expressed in his posts on Science-Based Medicine are his and his alone and that all writing for this blog is done on his own time and not in any capacity representing his place of employment. His...
The cancer screening kerfuffle erupts again: “Rethinking” screening for breast and prostate cancer
I see that the kerfuffle over screening for cancer has erupted again to the point where it’s found its way out of the rarified air of specialty journals to general medical journals and hence into the mainstream press. Over the last couple of weeks, articles have appeared in newspapers such as the New York Times and Chicago Tribune, radio networks like NPR,...
Are one in three breast cancers really overdiagnosed and overtreated?
Screening for disease is a real pain. I was reminded of this by the publication of a study in BMJ the very day of the Science-Based Medicine Conference a week and a half ago. Unfortunately, between The Amaz!ng Meeting and other activities, I was too busy to give this study the attention it deserved last Monday. Given the media coverage of the...
PSA – To Screen or Not to Screen
Is the prostate specific antigen (PSA) test worth taking? It's, like, really complicated.
David H. Gorski, MD, PhD, FACS – Managing Editor
Personal blog: Respectful Insolence Email: [email protected] Twitter: @gorskon Instagram: @gorskon Mastodon: Mastodon [NOTE: If you Googled Dr. Gorski’s name and found information that concerns you (for example, a “TruthWiki” entry about Dr. Gorski), please scroll to “A note for potential patients Googling for information about Dr. Gorski” for an explanation. Thank you.] DAVID H. GORSKI, MD, PhD, FACS is Professor of Surgery...
Early detection of cancer, part 2: Breast cancer and MRI
Note: If you haven’t already, you should read PART 1 of this two-part series. It defines several terms that I will be using in this post, and I don’t plan on explaining them again, given that they were explained in detail in Part 1. Of course, if you’re a medical professional and already know what lead time bias, length bias, and stage...
The early detection of cancer and improved survival: More complicated than most people think
“Early detection of cancer saves lives.” How many times have you heard this statement or something resembling it? It’s a common assumption (indeed, a seemingly common sense assumption) that detecting cancer early is always a good thing. Why wouldn’t it always be a good thing, after all? For many cancers, such as breast cancer and colon cancer, there’s little doubt tha early...
Barriers to practicing science-based surgery
Much to the relief of regular readers, I will now change topics from those of the last two weeks. Although fun and amusing (except to those who fall for them), continuing with such material for too long risks sending this blog too far in a direction that no one would want. So, instead, this week it’s time to get serious again. A...