Why our fear of cancer is outdated — and harmful (David Ropeik, January 8, 2024, Washington Post)

We now know that tens of thousands of common breast, prostate and thyroid cancers that are detected early never go on to do any harm. People “overdiagnosed” with these types of cancer are understandably frightened and usually choose more aggressive treatment than their clinical conditions require. Such “fear-ectomies” cause great harm, leading to side effects that range from moderate to severe and include death itself. We spend an estimated $5.2 billion a year on such clinically unnecessary treatment, 3 percent of the total spent on all cancer care annually.

The Centers for Disease Control and Prevention reported that in 2017, nearly 16 million people were screened for cancer even though they were younger or older than those for whom screening is recommended, based on who is more likely to be helped or harmed (by false positives, the side effects from follow-up diagnostic tests, and aggressive treatment for clinically non-threatening disease discovered in screening). We spend a minimum of $9.2 billion per year on this overscreening.

A majority of people believe that most cancer is caused by environmental carcinogens. Yet we now know that cancer is principally a natural disease of aging, which allows DNA mutations that cause uncontrolled cell growth to accumulate. More than half of those diagnosed with cancer in the United States are at least 65 years old, while 87 percent of those who die of it are 50 or older.

Yet governments spend hundreds of billions of dollars each year to reduce the risk from environmental carcinogens, vastly more than on any other environmental health threat, including fine-particulate air pollution, which kills more than 100,000 people a year. We spend billions on organic foods, vitamins and supplements, as well as many other products that promise to reduce our risk of cancer but don’t. The public has voted against fluoridating the drinking water in public supply systems serving 30 percent of Americans, despite a lack of evidence to support the fear that fluoridation is a cancer risk. Fear of ionizing (nuclear) radiation, a vastly smaller cancer risk than commonly believed, has driven the cost of building nuclear power plants so high that this source of non-greenhouse-gas-emitting energy struggles to compete in the energy marketplace.