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Preventive Cancer Screenings Are Becoming Too Lax

Mammogram The first experiences we typically have with medicine and medical treatment when we’re young are usually reactive. You get a cut on your finger, and Mom washes it off and applies a Band-Aid. You catch a bad cold, and Dad gives you a spoonful of nasty-tasting cough syrup.

But the worst diseases, especially cancer, are rarely obvious when they first begin attacking our bodies. If you don’t have the condition diagnosed before the symptoms have become severe, you may already be past your best treatment window. This is why preventive screenings, which help to catch diseases early, are so critical to good health outcomes.

Detecting Cancer Early Through Screenings

The most common cancer screenings and tests, all of which are recommended by the American Cancer Society, include mammograms (for breast cancer) and screenings for colorectal cancer, lung cancer, cervical cancer, and prostate cancer. These are screenings that have all been found to save lives by detecting dangerous cancers early.

Cancer screenings aren’t recommended for everyone. Guidelines are usually based around a combination of your age and other factors that might make you “high risk” (e.g., lifestyle, environment, family history or a combination). For instance, the long-standing recommendation for mammograms has been that women 40 and over should get them annually or even earlier for women whose relatives have had breast cancer.

Guidelines Becoming More Lax

Recently, however, there has been a loosening of many of these recommendations. The influential U.S. Preventive Services Task Force (USPSTF), an independent federal panel of primary care physicians and epidemiologists that evaluates scientific evidence on screening efficacy, issues guidance that is in turn also recommended by respected organizations like the CDC. Some of their guidelines have been controversial, especially their recommendation for mammograms, suggesting women ages 50 to 74 get them every other year.

The logic is that it’s not worth it for women in their 40s to get mammograms because they are a low-risk group and mammograms can often result in false positives. These false positives may lead to stress, additional scans, biopsies and other unnecessary procedures. There is also the possibility of finding growths or cancers that don’t ultimately pose serious health risks but may result in the patient getting unnecessary treatments like lumpectomies and radiation therapy.

Doctors And Radiologists Resist New Recommendations

Many physicians and specialists are not on board with the newer guidelines. A recent study found that 81% of doctors still suggest mammograms for women 40 to 44 — and even more (88%) make that recommendation for women from ages 45 to 49.

The American College of Radiology has even released a strong statement against the USPSTF guidance, emphasizing that if these guidelines are followed, “up to 10,000 additional, and unnecessary, breast cancer deaths” may result in the U.S. every year, along with thousands more having to undergo treatments for advanced cancer like surgeries, mastectomies and chemotherapy.

Issues With Other Screening Standards

There has also been some pushback against USPSTF guidelines on screenings for cervical cancer. This cancer claims over 4,000 victims per year in the U.S., which is a relatively low number precisely because it is often identified early when women get regular gynecological exams. The USPSTF’s current recommendation is for women to get either a pap smear or HPV testing, but the American Cancer Society, the American Society for Colposcopy and Cervical Pathology and the American Society for Clinical Pathology all suggest doing both tests (also known as “co-testing”) instead.

On the upside, the USPSTF is now advocating for annual lung cancer screenings for many smokers, which could save a lot of lives given that the disease kills a shocking 1.8 million people worldwide each year. Unfortunately, however, only a small number of affected people are getting lung cancer screenings so far, likely because more comprehensive screening programs still need to be implemented.

An Ounce Of Prevention Is Worth A Pound Of Cure

Preventive screenings are certainly not perfect. Both false positives and false negatives can potentially occur, and there is the possibility that the process or the results could cause unnecessary anxiety. But preventive screenings also save many lives, and loosening guidelines for when and how often to get these screenings means fewer people will benefit from that advanced warning.

It’s no wonder doctors and radiologists have been reluctant to embrace more lax standards, as they are on the front lines with patients and see the effects of screenings firsthand. They know the relief of catching a fast-growing malignant tumor early while a patient is still in the prime of their life. While women in their 40s may be an overall low-risk group for breast cancer, they are still relatively young and have a lot to lose — so why not be safe rather than sorry?

Turning Experience Into Advocacy

Given the worrying trend in the loosening of cancer screening guidelines, it is critical that all those involved in the healthcare industry share the benefit of their knowledge on this matter. Healthcare tech companies have an important role because they design the tools for screening, and it is their task to continue developing superior technology to better diagnose and treat disease. But they should also be advocates for the people they serve by weighing in with their expertise. Whether they’re releasing statements on guidelines, conferring with professional associations and industry groups or offering advice to patients directly, specialists in healthcare technology can help save more lives by encouraging people to embrace the power of prevention.

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Morris Panner HIMSS

About Morris Panner

As CEO of Ambra, Morris Panner leads the company on its mission of delivering better care through better technology. Morris is an active voice in the cloud and enterprise software arena, focused on the services and healthcare verticals. He is a frequent contributor to business, healthcare, and technology publications. Before Ambra, Morris built and sold an industry-leading business-process software company, OpenAir, to NetSuite (NYSE:N). He once served as the US Embassy Resident Legal Advisor in Bogota, Colombia; and his first job ever was as a janitor at his old high school while on summer break from college. Both of these very different experiences taught him valuable lessons about the human condition, and make him cherish his time with family that much more. Morris has a BA from Yale University and a JD from Harvard University.

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