Chuck McClung, Florida Today
Consumer Reports, a monthly magazine that rates everything from cars to cellphones, breaks new ground in its March issue by weighing in on 11 cancer screenings.
The magazine said eight of those tests -- for bladder, lung, skin, oral, prostate, ovarian, pancreatic and testicular cancers -- should be avoided by most people unless they have the highest risk factors. Otherwise, the tests are not worth the money or risks.
Risks include procedures such as a biopsy that can lead to infection, the magazine said. And some of the screenings can provide false positives.
"The medical and public-health community has systematically exaggerated the benefits of screening for years and downplayed the harms," said Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, in the article.
The ratings received mixed reviews with some physicians. Dr. Todd Panarese, a Brevard, Fla., physician, was critical of the simplistic approach the magazine took.
"It looks like a classic article written for a layperson that includes some information but doesn't give enough to really make a smart decision on some of their recommendations," said Panarese, medical oncologist at Cancer Care Centers of Brevard in Melbourne. "We're trying to find cancers as best we can, but unfortunately, we have somewhat limited tools to do so. Our tools are not perfect."
Dr. Ashish Dalal, a medical oncologist/hematologist with Space Coast Cancer Center, said the ratings are in line with a panel of experts that evaluates scientific evidence on clinical preventive services.
"I think I agree with most of what they say, purely because it seems they are following recommendations from the U.S. Preventive Services Task Force," Dalal said. "That is one of the most reliable recommendations for screening. Everything is based on evidence."
The three screenings with benefits that outweigh the harms are for cervical, colon and breast cancers. But the article said mammograms should begin at age 50, not 40. A controversy erupted when the task force first recommended mammograms at age 50 in 2009. The group backed down after backlash from U.S. doctors, and said women younger than 49 should talk their doctors to see whether the benefits outweigh the harms of testing. The magazine concurred.
Dr. John Santa, director of the Consumer Reports Health Ratings Center in Yonkers, N.Y, said the ratings are directed at specific consumers.
"The task force and (Consumer Reports) are focusing on true prevention for people who don't have symptoms and are not at high risk," he said.
He also said one of the problems in the medical community is that doctors don't uniformly test patients for cancer.
"There's is a lack of cohesiveness and agreement about how to do screenings. We're just trying to contribute a dialogue that hopefully will result in more consistency," Santa said.