Why Does Cancer Screening Persist Despite the Potential to Harm?

2021 ◽  
pp. 097172182096025
Author(s):  
Stacy M. Carter

Population screening for early-stage cancer or cancer precursors began in the mid-twentieth century, with the goal of reducing suffering from cancer illness and lengthening average life by preventing cancer deaths. Since the establishment of cancer screening, concerns have emerged that it may be doing considerable harm; despite this, screening practices have remained relatively intractable. This intractability in the face of harm is the central problematic of my analysis. I reinterpret a large study of breast, cervical and prostate cancer screening completed recently by our Australian research group, working across empirical bioethics, public health and social science. I suggest three reasons why cancer screening might persist as it does, and thus reach conclusions about what might be required to make cancer screening systems more responsive to the potential for harm.

2016 ◽  
Vol 3 (3) ◽  
pp. 176 ◽  
Author(s):  
Mara M Epstein ◽  
Daniel M Frendl ◽  
Hassan Fouayzi ◽  
Richard Krajenta ◽  
Benjamin A Rybicki ◽  
...  

2020 ◽  
Vol 27 (4) ◽  
pp. 215-222
Author(s):  
Cheryl E Peters ◽  
Paul J Villeneuve ◽  
Marie-Élise Parent

Objectives If prostate cancer screening practices relate to occupation, this would have important implications when studying the aetiological role of workplace exposures on prostate cancer. We identified variations in screening by occupation among men in Montreal, Canada (2005–2012). Methods Prostate specific antigen testing and digital rectal examination (ever-screened and frequency of screening, previous five years) were examined among population controls from the Prostate Cancer & Environment Study. Face-to-face interviews elicited lifestyle and occupational histories. Multivariable logistic regression was used to estimate the odds of ever-screening for the longest-held occupation, adjusting for potential confounders. Negative binomial models were used to examine relationships with screening frequency. Results Among 1989 controls, 81% reported ever having had a prostate specific antigen test, and 77% a digital rectal examination. Approximately 40% of men reported having a prostate specific antigen test once a year, on average. Compared with those in management or administrative jobs, men in primary industry (odds ratio 0.26, 95% confidence interval 0.10–0.65), construction (0.44, 0.25–0.79), machining (0.45, 0.21–0.97), and teaching (0.37, 0.20–0.70) were less likely to have undergone prostate specific antigen screening. Results were similar when considering the most recent job. Conclusions Our findings highlight substantial variations in prostate cancer screening by occupation. Men in occupations where carcinogen exposures are more common are less likely to participate in prostate screening activities. This could be an important source of bias, and occupational studies of prostate cancer should account for screening practices.


2017 ◽  
Vol 43 (1) ◽  
pp. 33-37
Author(s):  
Laura Donnelly ◽  
Kevan M. Sternberg ◽  
Takamaru Ashikaga ◽  
Mark K. Plante ◽  
Scott D. Perrapato

2017 ◽  
Vol 12 (2) ◽  
pp. E53-8 ◽  
Author(s):  
Jason Paul Akerman ◽  
Christopher B. Allard ◽  
Camilla Tajzler ◽  
Anil Kapoor

Introduction: This study serves as an update of prostate cancer screening practices among family physicians in Ontario, Canada. Since this population was first surveyed in 2010, the Canadian Task Force on Preventive Health Care (CTFPHC) and the United States Preventive Services Task Force (USPSTF) released recommendations against prostate cancer screening.Methods: An online survey was developed through input from urologists and family practitioners. It was distributed via email to all members of the Ontario Medical Association’s Section on General and Family practice (11 657 family physicians). A reminder email was sent at two weeks and the survey remained active for one month.Results: A total of 1880 family physicians completed surveys (response rate 16.1%). Overall, 80.4% offered prostate cancer screening compared to 91.7% when surveyed in 2010. Physicians new to practice (two years or less) were the most likely to not offer screening (24.6%). A combination of digital rectal exam (DRE) and prostate-specific antigen (PSA) remained the most common form of screening (58.3%). Following the release of the CTFPHC recommendations, 45.6% of respondents said they now screen fewer patients. Participants were less familiar with national urological society guidelines compared to task force recommendations. The majority (72.6%) of respondents feel PSA screening leads to overdiagnosis and treatment. Those surveyed remained split with respect to PSA utility.Conclusions: Data suggest a decline in screening practices since 2010, with newer graduates less likely to offer screening. CFTPHC and USPSTF recommendations had the greatest impact on clinical practice. Those surveyed were divided with respect to PSA utility. Some additional considerations to PSA screening in the primary care setting, including patient-driven factors, were not captured by our concise survey.


2018 ◽  
Vol 9 (6) ◽  
pp. 51-56 ◽  
Author(s):  
Kehinde Joseph Awosan ◽  
Edzu Usman Yunusa ◽  
Ngwobia Peter Agwu ◽  
Suleiman Taofiq

Background: Halting the rising burden of prostate cancer across the globe has become a major public health challenge with the absence of intellectual consensus on the effective strategies for its prevention. However, knowledge of the disease and uptake of prostate cancer screening remain indispensable in mitigating the dire consequences of the prevalent late presentation of patients with the disease in sub-Saharan Africa.Aims and Objectives: This study was designed with an aim to assess prostate cancer knowledge and screening practices among men in Sokoto, Nigeria.Materials and Methods: A descriptive cross-sectional study was conducted among 300 participants (selected by systematic sampling technique) attending the medical and surgical outpatient clinics of UDUTH, Sokoto, Nigeria. Data were collected with a pretested, structured questionnaire and analyzed using IBM SPSS version 20 computer software.Results: The mean age of the respondents was 53.13 ± 7.92 years. Only 15 (5.0%) and 4 (1.3%) of the 300 respondents were aware of prostate cancer and prostate cancer screening respectively. Most of the respondents (95.0%) had poor knowledge of prostate cancer, and none of them have ever had a prostate cancer screening test done, with the most commonly cited reason being lack of awareness (98.6%).Conclusion: This study showed poor knowledge of prostate cancer and zero uptake of prostate cancer screening among the participants. These findings highlight the need for government and healthcare providers to sensitize the public on prostate cancer and its prevention, in addition to facilitating unrestricted access of those at risk to prostate cancer screening services.Asian Journal of Medical Sciences Vol.9(6) 2018 51-56


2016 ◽  
Vol 82 ◽  
pp. 73-76 ◽  
Author(s):  
Michael E. Rezaee ◽  
Charlotte E. Ward ◽  
Brian D. Odom ◽  
Martha Pollock

2017 ◽  
Vol 198 (6) ◽  
pp. 1230-1240 ◽  
Author(s):  
Daniel J. Lee ◽  
Katherine Mallin ◽  
Amy J. Graves ◽  
Sam S. Chang ◽  
David F. Penson ◽  
...  

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