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Digital Subscriptions > Skeptic > 24.4 > How Much Longer Will Cancer Screening Myths Survive?

How Much Longer Will Cancer Screening Myths Survive?

IT HAS BEEN 20 YEARS SINCE DR. ANGELA RAFFLE published an article in the prestigious medical journal The Lancet with the provocative title “How long will screening myths survive?”1 Although screening myths have been discussed extensively in peer reviewed articles since Raffle’s publication, I think the public still needs balanced information. This article reviews important concepts and myths of screening.

Screening is the systematic search for a specific disease, through medical tests, in people without symptoms of that disease. Common population cancer screening programs include screenings for breast, cervical, colorectal, and prostate cancers.

One of the myths discussed in Raffle’s article was regarding the comment “A recent analysis…has shown a reduction in the risk of cervical cancer by 95% for at least 8 years.” Another example is the statement made by Rudy Giuliani, former New York City Mayor, who had been diagnosed with prostate cancer. When he was running for president in 2008, Giuliani tried to make a political statement that the American health system was much better than the “socialized” medicine of England, when he claimed he had an 82% of chance of surviving prostate cancer in the United States, compared to only 44% in England.2

Probably without knowing it, Giuliani compared patients that were diagnosed in different ways, making his comparison invalid. Screening in the United States was much more common than in England. It is not possible to compare screened patients with nonscreened patients due to the healthy screened-effect— people who get screened tend to be healthier, physically fit, non-smokers, and to have fewer social problems than those who do not get screened.3 That is why randomization is used in clinical trials—to assure that the groups are equal with the only difference being the intervention under analysis. In a screening context, however, those numbers could have come from randomized clinical trials, and it still would have been misleading.

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About Skeptic

UNDERSTANDING FLAT EARTHERS WHO SAYS THE EARTH IS FLAT, AND WHY? COLUMNS The SkepDoc: Water Fluoridation: Public Health, Not Poison, by Harriet Hall, M.D. • The Gadfly: Are You in the 43 Percent?, by Carol Tavris DEBATE Does God Exist? A Rebuttal of Theologian Brian Huffling • God is Not a Moral Being: A Response to Gary Whittenberger on the Problem of Evil ARTICLES Understanding Flat Earthers • Shroud of Turin Update • The Girl Who Smelled Blue: The Colorful Case of Willetta Huggins • How to Navigate Contentious Conversations • How Much Longer Will Cancer Screening Myths Survive? • Nationalistic Pseudohistory in the Balkans • “Prove that I am Wrong!” What QAnon, Descartes, and Brains in Vats Have in Common REVIEWS Reviews of Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness • The Human Swarm: How Tolerance of Strangers Creates Society • Darwin’s Apostles: The Men Who Fought to Have Evolution Accepted, Their Times, and How the Battle Continues • Forensic Science Reform: Protecting the Innocent • The Psychology and Sociology of Wrongful Convictions: Forensic Science Reform • Blinding as a Solution to Bias: Strengthening Biomedical Science, Forensic Science, and Law JUNIOR SKEPTIC Victorian England’s Jurassic Park, by Daniel Loxton