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Should You Get Screened for Cancer?

By March 17, 2009

Should you get screened for cancer? The answer may surprise you.

There are several recommended cancer screenings as we age - papsmears, mammograms, colonoscopies, PSA tests - screenings that are supposed to save our lives, right? But what if the test caught cancer that wasn't necessarily dangerous? And what if the treatment you underwent caused more problems than it prevented?

These are questions being asked in the April 2009 Reader's Digest. The cover story, "Cancer Screening: Doing More Harm than Good?" examines the most common screening tests for cancer and the good, and bad, that can result from them. Despite wide-spread thinking that catching all cancers early reduces our risk of death, this may not always be true.

I've broached this subject before, wondering if the elderly should be screened for cancer. It may not be in the best interest of an elderly woman with a chronic disease (think diabetes, heart disease, dementia) to endure a mammogram that might detect breast cancer when she's more likely to die of something else anyway. This sentiment is shared by others:

Excerpt from "Cancer Screening: Doing More Harm than Good?"

To Screen or Not to Screen? The fact is, there's no single answer. It depends on many factors, including how old you are, what other diseases you have, and what you value most in terms of your health. Dennis Fryback, PhD, is a former member of the U.S. Preventive Services Task Force, a group of experts convened by the federal government to make recommendations about screening. The task force recommends colonoscopy every ten years for people between the ages of 50 and 75, yet the 61-year-old Fryback has concluded it does not make sense for him to get screened.

He came to that decision in part because he has no family history of colon cancer. If he did, his chances of getting it would increase, and so would the odds he'd benefit from the test. He also knows that getting the exam requires at least a day of taking laxatives to clean out the colon and then facing the possibility of a perforation from the procedure, a risk that goes up with age. He balanced the possible reduction in his chances of dying of colon cancer against his other health problems. He had a heart attack last year and suspects he will die of heart disease before a colon polyp has a chance to kill him.

Still, it's hard for most of us to decline testing that may save our lives. How can you decide whether you or your loved one should be tested for cancer? The Reader's Digest is offering it's readers access to cancer screening decision aids from Health Dialog at healthdialog.com to help you make that important decision.

If you decide to be screened for cancer and end up with a positive diagnosis, the decisions don't get much easier. Here are some resources to help you make decisions along the way:

Making Difficult Health Care Decisions: Goals of Care
Your Right to Know about Treatment Options
6 Questions for Your Doctor about Treatment Options
Palliative Chemotherapy: 5 Questions for Your Oncologist

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