How Necessary is Screening?

Screening is meant to detect health problems before their ‘owner’ gets aware of them. Many ailments do only cause problems, complaints or even pain, once they’re too big to be treated successfully. Therefore one wants to find a problem that is still small enough to be healed.

That’s why cholesterol is considered to be more evil than Bin Laden – it will slowly, slowly block up your blood vessels until no blood can get through any more and one is taken to the eternal hunting grounds and beer drinking academies by having a heart attack or stroke.

But: before this happens, cholesterol had been soaring high for many, many years and if one would have done something in time, which is possibly 20 years ago, one could still be enjoying worldly affairs, such as finding a parking lot in almuñécar in August. The same sort of thinking applies to chest X-rays for smokers, PSA-tests for men and mammography’s for women.

There is one additional concern though, which is not always considered enough: the testing itself should not bear greater health risks than the condition one wants to find or rather not find.

A few years ago, jobless American radiologists started promoting a full-body-TAC-scan as the ultimate preventative diagnostic tool even for cancers worse than Bin Laden. What they did not tell the public was, that the procedure itself exposes the individual to such ridiculously high doses of hazardous radiation, that this screening itself can cause cancer. What a cynical self-fulfilling-prophecy…

But even though the idea of ‘prevention’ has possibly been invented and very successfully applied by the insurance companies, it naturally bears it’s beauty. Feeling secure nowadays involves not having to worry about one’s health. Therefore all cut-backs in national-health systems hit a neuralgic point of their users: In the UK as much as in Germany and now as well in America.

Since 2002, the Preventive Services Task Force recommended screening mammography every one to two years for all women, 40 or older. Now there is a 2009 update of guidelines based on a systematic review of benefits and harm of screening:

Nowadays, the task force recommends against screening of women younger than 50, unless there is a personal risk factor.

For middle-aged women, 50 to 74 years of age, they recommend biannual screening.

For women of 75 and older current scientific evidence is insufficient to assess benefits and harm of screening mammography. (mind boggled?)

Understandably, breast cancer and the related screening generates anxiety among many women. Reactions therefore will be characterized by confusion, and even outrage. ‘Public services ignoring the needs of the people…’, “Everything is just going downhill and getting worse …” etc.

But: scientists get increasingly conscious about collateral damages one produces when using high-tech medicine and therefore I will repeat it again and again: less can be more (healthy, in that case).

Just recently they found out, that patients who received standard oncological treatment for metastatic lung cancer did not live as long as other patients who declined chemotherapy and were treated only with palliative care!

So? There is not the same medicine for everybody. What’s good for a goose is not good for a gander (Not surprised, are you?).

What you need is a doctor, you can trust and who will design a personalized screening, taking into consideration your genes, habits, complexion, fears and purse.

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