We Are Sunshine

HEADLINE STORY: ACS bombshell admits cancers are being over-diagnosed. Melanoma could lead the list.

Thursday, October 22nd, 2009

OCT. 22, 2009 — An American Cancer Society bombshell declaring that cancer screenings themselves are responsible for over-diagnosis of cancer most likely applies more to skin cancer diagnosis than any other cancer.

“Over-diagnosis” of cancer — the practice of calling benign growths “cancer” thereby creating a cavalcade of unintended health care consequences – is enough of a public issue that ACS this week issued a statement saying that the benefits of “screening” for many cancers, which in many cases leads to overdiagnosis, has been overstated.

2009-10-22-over-diagnosis-copy.jpg“We don’t want people to panic. But I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated,” Dr. Otis Brawley, the American Cancer Society’s chief medical officer, told the New York Times in a story published Wednesday.

The story targeted mainly prostate cancer screenings. “The cancer society, which with more than two million volunteers is one of the nation’s largest voluntary health agencies, does not advocate testing for all men. And many researchers point out that the PSA prostate cancer screening test has not been shown to prevent prostate cancer deaths,” the Times reported.

But a study published in the British Medical Journal last month showed that melanoma skin cancer incidence is not really increasing, but that aggressive screening has led to an increase in diagnosis — a finding suggested more than a decade ago by Emory University dermatologists.

“In recent years there has been a sharp rise in reported cases of malignant melanoma, the deadliest form of skin cancer. But a British study has found evidence that the epidemic may be due at least in part to ‘diagnostic drift,’ a growing tendency to identify and treat benign lesions as malignant cancers,” The Times reported in a Sept. 28 story. “The findings may raise the temperature in an already-heated controversy.”

Broken down by thickness, the British study showed that only the thinnest lesions were increasing and that the cure rate of removal of those lesions was 100 percent, raising questions as to whether or not they were truly malignant lesions or simply benign tissue.

“Overdiagnosis is pure, unadulterated harm,” Dr. Barnett Kramer, associate director for disease prevention at the National Institutes of Health, told The Times.

According to The Times article, “Finding those insignificant cancers is the reason the breast and prostate cancer rates soared when screening was introduced, Dr. Kramer said. And those cancers, he said, are the reason screening has the problem called overdiagnosis — labeling innocuous tumors cancer and treating them as though they could be lethal when in fact they are not dangerous.”

To read The New York Times coverage of this story click here.