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Why Cancer Screening Doesn’t Save Lives

by Dr Carl Heneghan and Dr Tom Jefferson
16 April 2024 7:30 PM

Illness is identified by taking a history, examining symptoms and signs, and often by taking some tests. 

Many of us seem unwell as much testing is happening – roughly 50 million diagnostic tests, 500 million biochemistry and 130 million haematology tests are performed annually in the NHS. In the U.S., it’s another order of scale, with 14 billion laboratory tests ordered annually. Testing is also on the increase: in primary care, it increased by 8.5% per year between 2000 and 2015 across all ages. The proportion having more than one test has also increased significantly. However, there are wide variations in testing, which is unlikely to be explained by clinical need.

The CDC reports that 70% of medical decisions depend on laboratory test results, but what happens when these decisions do not benefit patients or would never have caused any symptoms or problems? 

Overdiagnosis transforms people into patients unnecessarily by identifying problems that were never going to cause harm or by medicalising ordinary life experiences through expanded definitions of diseases.

As an example, the most extensive study to date of the Prostate-Specific Antigen (PSA) blood test to screen for prostate cancer found it only had a negligible impact on reducing deaths. Still, it led to overdiagnosis and missed the early detection of some aggressive cancers.

The trial included 415,357 men between the ages of 50 and 69. They were randomly assigned to a single invitation for PSA screening or a control group without PSA screening. The participants were followed up for a median of 15 years.

So, while a single invitation for PSA screening reduced prostate cancer deaths by a tiny amount, roughly one in 1000 men tested, it had no impact on all-cause deaths, which is the outcome you are concerned about. 

PSA screening did increase the detection of low-grade and localised disease but not intermediate, high-grade or distally advanced tumours. As a consequence, about one in six cancers were over-diagnosed. These men went on to have invasive treatments they didn’t need, while the test failed to spot aggressive cancers requiring intervention – creating stress and worry for no reason. 

You might expect all this extra testing to translate into better outcomes. Yet, medical practices with the highest PSA rates do not see reduced prostate cancer mortality. However, they do see increases in the number of downstream diagnostic and surgical procedures with potentially harmful consequences.

A slight reduction in prostate cancer deaths weighed against the lack of all-cause mortality and overdiagnosis that comes with all the worry and stress means the benefits of testing often do not outweigh the potential harms. 

Over-detection and over-definition of diseases are major causes of over-diagnoses, which ultimately cause more harm than benefit. When it comes to testing, more is not always better.

Dr. Carl Heneghan is the Oxford Professor of Evidence Based Medicine and Dr. Tom Jefferson is an epidemiologist based in Rome who works with Professor Heneghan on the Cochrane Collaboration. This article was first published on their Substack, Trust The Evidence, which you can subscribe to here.

Tags: HealthNHSOver-diagnosisOver-medicalisationProstate cancerScreening

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    22 Comments
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    Lockdown Sceptic
    Lockdown Sceptic
    1 year ago

    Killing Farming Is Killing Humanity 

    leaflet to print at home and deliver to neighbours or forward to politicians, media, friends online. 

    09a-Killing-Farming-Is-Killing-Humanity-MONOCHROME-copy
    34
    -4
    NeilParkin
    NeilParkin
    1 year ago

    “Tory capitulation to the soft-Left orthodoxy has ruined Britain”

    The late George Carlin used to talk about ‘where interests converge’. That there didn’t need to be a formal conspiracy driving us towards a totalitarian future, because the people driving it went to the same university, same country club, their children went to the same schools, and so on. They didn’t need it writing down. They knew what was good for them, and they didn’t rock the boat.

    This in my mind is what has happened to parliament and our MP’s. Far too many people with the same outlook on life and all things. The Labour party in government is likely to bring this to a whole new level. No longer the Union man off the steel-works shop floor, arguing with the landowners and bankers. The Commons are full of people who have went to the same Universities, read the same subject, go to the same dinner parties and gained their work experience in local councils, Think Tanks, NGO’s and charities.

    Last edited 1 year ago by NeilParkin
    63
    0
    NeilParkin
    NeilParkin
    1 year ago

    “‘Disbelief’ as under-manned Royal Navy seeks to re-deploy officers to diversity and inclusion team”

    Disbelief, really.? Its exactly what I would have expected from something that has lost its connection with core values, and its true mission. Its very sad.

    Here’s a little video of when our Navy was filled with courageous recruits.

    https://youtu.be/gFeUO1R3-eg?t=161

    40
    0
    NeilParkin
    NeilParkin
    1 year ago

    “The SNP’s Covid reckoning”

    Its not the language. I can overlook the language. It is the utterly narcissistic way that they treated the entire situation, and the opportunism of using it for other ends that should hang them. It was nothing more than a game that they were playing. However it was one that required the deaths of real people who were doing nothing more than being caught up in a gigantic game of ‘who’s got the biggest dick’..?

    58
    0
    WyrdWoman
    WyrdWoman
    1 year ago

    “Britain halts aid to UN agency after claims staff helped Hamas attacks” 

    Article behind paywall.

    Britain, Italy, Canada and Australia followed the United States in withdrawing financial support for the UNWRA for Palestinian refugees. [Plus Germany and Finland so far. Ireland following international law and maintaining payments pending investigations.] 

    https://www.politico.eu/article/italy-canada-australia-united-states-funding-unrwa-united-nations-hamas-israel/

    -while 400,000+ people literally starve. Its payback for the ICJ interim decision. 

    As Max Blumenthal notes:

     https://twitter.com/MaxBlumenthal/status/1751110691103113456

    “2003: GW Bush justifies invading Iraq with testimony by Ibn al-Shaykh Al-Libi, who was tortured into confession by CIA-trained Egyptian security services.
    2024: Biden [and Sunak et al] justifies cutting UN aid to Gaza with testimony by Palestinian detainees tortured into confession by Israeli security services.”

    And as posted elsewhere: ‘So an allegation that 7 people from 30,000 employees derived from intelligence ( confessions) made under torture from prisoners and without any court ruling or evidence presented is now acted upon by western nations. Hypocrites to the procedures of law. As the west always says, wait for a court to prove allegations especially when its against politicians for corruption etc. All this the day after an adverse IJC finding against Israel’ [which has wanted UNWRA out of Palestine for years] How convenient.

    Do Sunak and all those other soulless hegemonic puppets realise that they could eventually be done for complicity in genocide?

    #Notinmyname

    24
    -23
    DHJ
    DHJ
    1 year ago
    Reply to  WyrdWoman

    “they could eventually be done for complicity in genocide”

    Quite the opposite, I think we can safely conclude they know it will never happen.

    The same people just presided over the killing of swathes of their own electorate without consequence other than the odd embarrassing headline.

    29
    -1
    WyrdWoman
    WyrdWoman
    1 year ago

    Dr Mark Trozzi, professor, ER specialist & covid warrior, has his licence revoked in Canada, an egregious political decision that has nothing to do with patient care.

    https://drtrozzi.substack.com/p/unrepentant-cpso-revokes-dr-trozzis

    In reaching its decision, the Tribunal rejected Supreme Court cases, dating from 1939, which hold that Canadians enjoy an absolute constitutional right to express minority opinions on any subject. This allowed the Tribunal to rule that the College has a right to regulate the expression of its members in the name of the public interest.
    The Tribunal’s ruling also rested on the prior discipline hearing decision, where the Tribunal found that Dr. Trozzi had caused harm by spreading misinformation, even though expert witnesses for the College failed to tender evidence that Dr. Trozzi’s statements had caused harm to a patient or a member of the public.
    In support of its ruling, the Tribunal also rejected a 41-page report Dr. Trozzi submitted in 2021 in which he defended himself against the College’s initial allegations, citing 29 references from mainstream sources such as Lancet, the New England Journal of Medicine, Public Health Ontario and Statistics Canada. This was done without mentioning that the College’s main expert witness, Dr. Andrew Gardam, had admitted on cross-examination during the discipline hearing that he had never attempted to refute the Trozzi report.

    39
    -1
    Monro
    Monro
    1 year ago

    “‘Weakened’ Ukraine can’t launch offensive against Russia and must focus on defence, say US officials” 

    Good idea because this (labelled ‘fake’ by Russian authorities, ring any bells?) is what it is like for Russian families:

    ‘The Russian government has turned its backs on soldiers and their families.
    We’re being betrayed and exterminated by our own people. […] We were f*cked over and you’ll be f*cked over. All this time, all they showed us was lazy stability, reliability, and safety. We remember how the president promised that reservists wouldn’t be called up, that only professional volunteers would fight in the special military operation. And then they sent our loved ones to Ukraine. The promises proved empty. Many will never return. Mobilization turned out to be a terrible mistake. We were punished for our law-abidingness. Behind the smokescreen of stability, our men pay with blood, and we pay with our health and tears.

    The president has declared 2024 to be the Year of the Family. It’s ironic, given that wives are crying without their husbands, children are growing up without fathers, and many have already become orphans. Meanwhile, a satanist cannibal who re-offended after his first prison sentence will be released again in six months, having atoned for his serial murders by fighting in the special military operation. Our president does have a sense of humor after all! Apparently, our motherland is being liberated for the very best of society: killers, drunks, migrants, and outrageously wealthy officials and their children (speaking of whom, why aren’t they in the trenches?).’

    The Way Home December 2023

    Last edited 1 year ago by Monro
    5
    -30
    WyrdWoman
    WyrdWoman
    1 year ago

    “The ICJ has been captured by antisemitic propaganda” 

    Article behind a paywall but anyway – was under the impression that the whole right to self defence thing wasn’t part of international law for an occupying force which Isreal is identified as being with regard to Gaza, the West Bank, Golan Heights and the southern part of Lebanon. This has been discussed many times by numerous geopolitical experts over the years and particularly in the last few months. It appears to be a particularly West-centric viewpoint which ignores both existing law and the overwhelming view of world opinion, especially the Global South. Don’t exactly know what the complaint is anyway as Israel and it’s supporters – as expected – have completely ignored any and all measures the ICJ have stipulated. If you’re above the law, why complain about it?

    What’s probably getting them rattled isn’t the ICJ interim decision per se, but the consequences of it on the global ‘street’: As Dr Razmy Baroud, editor in chief of the Palestine Chronicle has noted in a very thoughtful piece:

    We should no longer submit to the direct accusation that boycotting Israel is an act of antisemitism. To the contrary, boycotting Israel now has some serious and legitimate legal basis in international law. 

    https://www.palestinechronicle.com/as-we-celebrate-gaza-is-disappointed-with-icj-ruling-this-is-why/

    19
    -19
    DHJ
    DHJ
    1 year ago
    Reply to  WyrdWoman

    Given the following views:

    Legally, the Israelis are occupiers.

    Ideologically, all the non-Jews are occupiers.

    Which one is consistent with the response of the Israeli regime?

    1
    -6
    huxleypiggles
    huxleypiggles
    1 year ago
    Reply to  WyrdWoman

    International law?

    That’s just fiction. Only when it suits.

    8
    -1
    MichaelM
    MichaelM
    1 year ago

    Morning All

    I was looking for some commentary to send to my brother on Chemtrails – he had never heard the term. I thought the DS is bound to have written about this, given its nefarious anti-democratic nature and related denials by the MSM, but nothing at all popped up on entering “chemtrails” into the Search Box.

    DS Team – not sure if you agree that this would be a good topic for a researched article.

    25
    -2
    AethelredTheReadier
    AethelredTheReadier
    1 year ago
    Reply to  MichaelM

    Morning Michael,
    A good place to start is Dane Wigington’s website: https://www.geoengineeringwatch.org/
    He has been following this for a very long time. If you search for geoengineering online you’ll come across various articles purporting to be about ‘combating climate change’ or similar. Anyway, hope this helps.

    22
    -1
    Freddy Boy
    Freddy Boy
    1 year ago
    Reply to  AethelredTheReadier

    👍

    3
    0
    MichaelM
    MichaelM
    1 year ago
    Reply to  AethelredTheReadier

    Thanks Aethelred – that looks ideal.

    0
    0
    DS99
    DS99
    1 year ago
    Reply to  MichaelM

    Chemtrails seems to be one of those baffling so-called “conspiracy theories” because the evidence is pretty clear – I’ve seen with my own eyes on numerous occasions one or two planes creating a latticework of clouds in beautiful clear skies. I don’t live anywhere near a flight path and most days you wouldn’t see any planes in the sky at all. And yet, there seems to be a resistance to looking at it from sceptical sites. For example, the word “chemtrail” doesn’t appear on the Conservative Woman website when you put it in the search bar. I doubt the DS will cover it but thanks for raising what I consider to be an important issue.

    25
    -1
    MichaelM
    MichaelM
    1 year ago
    Reply to  DS99

    Thanks for that insight, DS99.

    “Curiouser and curiouser” – Lewis Carroll, Alice in Wonderland.

    “The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.” – George Orwell, from 1984.

    Last edited 1 year ago by MichaelM
    3
    0
    Freddy Boy
    Freddy Boy
    1 year ago
    Reply to  MichaelM

    Morning Mike I also have become interested in Chemtrails which I previously dismissed , due to having too much other stuff to digest ! We now live near the Welsh border & you can see criss cross patterns which are like layered waffles amongst the clouds ! Something is taking place & it won’t be for the best !!…

    16
    0
    MichaelM
    MichaelM
    1 year ago
    Reply to  Freddy Boy

    Evening, Freddy – totally agree with you.

    1
    0
    soundofreason
    soundofreason
    1 year ago

    “What is the real purpose of the German nuclear phase-out, and why is the policy shrouded in so much silence and mystery?” – Eugyppius on the German Government’s fights to keep secret records related to the shutdown of the country’s last nuclear plants.

    At the 2023 United Nations Climate Change Conference in Dubai, over 20 countries launched a Declaration to Triple Nuclear Energy; Germany was notably missing from the 16 European signatories.

    Bah! Germany could have signed that declaration. 3 times nothing is…?

    11
    0
    Free Lemming
    Free Lemming
    1 year ago

    “Tory capitulation to the soft-Left orthodoxy has ruined Britain” – Don’t blame Reform: Sunak’s party is unravelling because it succumbed to socialist delusions that were impossible to implement, says the Telegraph‘s Janet Daley.

    So says the DT. The rag that gleefully supported one of the biggest socialist coups in history in 2020. Too little too late. The ship has sailed.

    16
    -5
    JohnK
    JohnK
    1 year ago

    Electric car acceleration ‘makes crashes more likely’: The other side of the coin is that the other side is not aware of it, and may assume that there is enough time to nip across the gap, etc.

    4
    0

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