Cancer screening--benefits, harms and making an informed choice.
BACKGROUND
Screening is a two edged sword, with potential benefits and harms. Despite professional and public enthusiasm for cancer screening there are substantial harms, and increasing evidence that it is not always a good idea to detect cancer early. On the other side, the benefits of cancer screening are quite rare and have been oversold.


OBJECTIVE
This article discusses the potential harms of cancer screening and evidence for the benefits.


CONCLUSIONS
Well recognised harms include the psychological and physical harms of false positive and false negative tests. More recent research is uncovering what may turn out to be the biggest downside of cancer screening; the potential to uncover clinically irrelevant disease (pseudo-disease) and therefore harm from unnecessary treatment.
School of Public Health, University of Sydney, New South Wales. alexb@health.usyd.edu.au
Alexandra L
AL
Barratt
D003657:Decision Making; D042241:Early Diagnosis; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000592:standards; D009369:Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors