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Catching Cancer Early: Be Careful What You Screen For

By Richard Knox

True or false: It’s always better to catch cancer early.

Answer: False

But that absolutely doesn’t mean we should give up screening for early detection of cancer.

Yes, it’s confusing. But bear with me. Because two reports issued this week are a perfect illustration of why cancer screening is such a tricky topic.

Consider them both and you’ll have a better appreciation of the complexities of the issue. And why individuals and health policymakers need to think carefully about when to screen and what to do with the results.

One new report is about screening for thyroid cancer. It makes a strong case for why it’s not a good idea.

The other is about screening for cervical cancer. It’s an equally strong argument for why there’s not enough.

First, thyroid cancer screening. South Korea has gone in for it in a big way, as part of a national push for detecting all cancers for which there’s a screening test – cancer of the breast, uterine cervix, colon, stomach and liver.

Adenocarcinoma in Situ of the Cervix/Ed Uthman, flickr

Adenocarcinoma in Situ of the Cervix/Ed Uthman, flickr

South Korea is years ahead of the U.S in paying for cancer screening. Back in 1999, the government started providing free or very low-cost cancer screening, something that’s only now happening, and more cautiously, under the U.S. Affordable Care Act.

The Korean program doesn’t include thyroid cancer in its screening program. But so many hospitals and doctors have ultrasound machines – which can detect tiny thyroid tumors with a quick neck scan – that thyroid cancer screening has become routine in recent years, for a fee of $50 or less. It’s an easy sell, and an easy way to make money. Continue reading