October 12, 2011

YOU CAN RISK ILL HEALTH OR DEMAND IT:

You Have to Gamble on Your Health (H. GILBERT WELCH, 10/11/11, NY Times)

Personally, as a 56-year-old man, I choose not to be screened for prostate cancer (and, were I female, I believe I would choose not to be screened for breast cancer). Some of my patients have made the same choice, while others choose to be screened. That's O.K., because there is no single right answer.

Screening is like gambling: there are winners and there are losers. And while the few winners win big, there are a lot more losers.

It's easy to understand why. When doctors screen for early cancer, all the incentives -- cultural, financial, professional and legal -- line up in one direction: Don't miss it. As a result, doctors overreact to even the tiniest abnormalities, which leads to the two basic harms of screening: false-positive tests and overdiagnoses.



Posted by at October 12, 2011 6:55 AM
  

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