Study finds some cancers are ‘better left undiscovered’

Australians are increasingly being diagnosed with cancers that will do them no harm if left undetected or untreated.

Cancers better left undiscovered

Australians are increasingly being diagnosed with cancers that will do them no harm if left undetected or untreated, exposing them to unnecessary surgeries and chemotherapy, according to a new study published this week.

The research, led by Professor Paul Glasziou from Bond University, drew on data from the Australian Institute of Health and Welfare to compare how the lifetime risk of five cancers had changed between 1982 and 2012.

The study shows that compared to 30 years ago, Australians are much more likely to experience a cancer diagnosis in their lifetime.

The figures suggest that in 2012, 24 per cent of cancers or carcinomas in men were overdiagnosed. These included 42 per cent of prostate cancers, 42 per cent of renal cancers, 73 per cent of thyroid cancers and 58 per cent of melanomas.

For women, 18 per cent of cancers or carcinomas were overdiagnosed, including 22 per cent of breast cancers, 58 per cent of renal cancers, 73 per cent of thyroid cancers and 58 per cent of melanomas.

The figures are significant because of the harm that can occur from cancer treatment of patients who would never have had symptoms in their lifetime.

“Cancer treatments such as surgery, radiotherapy, endocrine and chemotherapy carry risks of physical harms,” the authors of the study reported.

“In the absence of overdiagnosis, these harms are generally considered acceptable.

“In the context of overdiagnosed cancers, however, affected individuals cannot benefit but can only be harmed by these treatments.”

The authors also refer to separate studies showing overdiagnosis could be linked to psychological problems.

“For example, men’s risk of suicide appears to increase in the year after receiving a prostate cancer diagnosis.”

The new study calls for urgent policy changes to tackle overdiagnosis.

Prof. Glasziou said increasing rates of diagnosis were a result of improvements and wider use of testing and screening.

“The problem is that some screening identifies abnormal cells that look like cancer but don't behave like cancer. However, reducing that problem is not easy, as some types of screening are important."

Prof. Glasziou said the way to reduce melanoma deaths may not be ever more advanced screening “but applying daily sunscreen” and research on better treatments.

“While much of the overdiagnosis is due to screening, many overdiagnosed cancer cases are incidental findings, that is, the patient is being tested for something else when the cancer is detected,” Prof. Glasziou said.

“Getting the balance right between too little and too much screening and testing will not be easy, but this is an important step.

“It is the first time that the risk of overdiagnosis has been quantified across five cancers, anywhere in the world.”

Associate Professor Katy Bell said that the findings also suggest an important role for health services such as the Australian Institute of Health and Welfare, in detecting potential overdiagnosis and alerting health policy decision makers to the problem early on.

“Patterns of increased test use, cancer incidence, or treatment rates, without corresponding rises in mortality could indicate emerging areas of overdiagnosis,” she said.

“People still need to remain vigilant when it comes to early detection of cancers, however they need to be informed and engage in shared decision making with their medical professionals about the harms of cancer screening and other associated procedures.”

What do you think about the findings of this study?

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COMMENTS

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older&wiser
29th Jan 2020
9:44am
Perhaps not 'undiscovered', but left alone. Get one sun spot removed, and it's the start of multiple, continual removals. My brother had one removed, and is now up to 18th removal. I had one diagnosed years ago, but with regular doctor checks, have left it alone, using my own choice remedy. We were both brought up on farm, both spending long times outdoors with job and hobby, and in our younger days, using sunscreen and hats were unheard of. Recent doctor check shows no others, and no problem with one I do have. "If it ain't broke, leave it alone".
Triss
29th Jan 2020
10:40am
I suppose the medical people are in a cleft stick. If a tumour that was diagnosed as a “left alone” turns into a life threatening cancer then the doctor runs the risk of being sued.

29th Jan 2020
11:03am
I have great faith in the melanoma surgeons and Professor type analysts. I have had chest surgery, removal of gallbladder, removal of 23 lymph glands, and as a result of being in my blood stream, eventually removal of two parcels of some 38x38x40mm from my brain. Have absolute faith in the surgeon, particularly brain surgeon. If people reckon he is over paid, I think he is under paid.

In my youth cooking yourself with sun exposure was standard. Doses of sun tan oil magnified, not assisted sun protection.

Unfortunately no one is expert on your mental capacity with some of the treatment.
Foxy
29th Jan 2020
11:51am
... just another "Job's for mate's" syndrome! They send you to Fred - Joe - Bill blah blah all making hundreds of dollars out of what started as a basic normal G.P. visit!(and often "wrong" diagnosis!)

They put a person under stress - revolting appointments etc. etc. (all telling you "different" things.) Did it happen to me? NO! I refuse to get on what I perceive to be the "Medical Merry-go-Round"! $$$$$'s !!

However I accompanied a dear friend of mine of many years and saw what happened to her! She has now turned into a "Google medical nutter" and hardly a week goes by where she is now attending the next Specialist/G.P. appt. because even tho' they say now "There is NOTHING WRONG with you" - she does not believe them!! Sad.

The minute you walk in their door - they are mentally adding up the $$$ signs they see "floating" over your head! Pathetic!
KSS
29th Jan 2020
1:02pm
Hang on Foxy, if the medics are telling your friend they can find nothing wrong with her yet she refuses to believe them and goes searching Dr Google for the next condition, then she has a mental problem. It is not the specialists that are saying she needs to see them. Rather it sounds like she is insisting even though there is nothing physically wrong. You call her a "Google medical nutter" which is hardly supportive. Perhaps you ccan use your influence to get her to a psychiatrist instead of blaming the medical profession.
Jingles
29th Jan 2020
12:26pm
My husband had biopsies for prostate cancer which were reported as negative. The Urologist told us to wait and see but because I had been employed by Peter Mac for many years I could not agree. If we had taken notice he would be dead by now because on opening him up it was discovered he had a very aggressive tumour which was fast growing despite the Urologist telling us prostate cancer is slow growing.
That was 10 years ago and the only side effect he had was weight gain due to the Xoladex he was on.
For the above reason I believe in using your common sense especially for cases of prostate cancer and I thank the fact that I had knowledge of cancer having worked in the area for years.
Pass the Ductape
29th Jan 2020
12:40pm
"People however need to be informed and engage in shared decision making with their medical professionals about the harms of cancer screening and other associated procedures.”
Fine words but…..
Having been through the process, I felt as a patient, that I was little more than an item revolving around on a conveyor belt. I tried to understand the pros and cons of what was to happening to me, but it seemed to me that rarely did anyone connected with the medical team have any time for answering questions about what I felt was important for me to understand - except for the most rudimentary and short answers given to circumvent the situation as quickly as possible.

For most of us it's one hell of a scary situation! Let’s face it - you may not make it.

It is after all your body - not theirs - and here you are, waiting to be sliced, diced, pricked and poked by a team of unknowns whom, despite their supposed qualifications, give away nothing but an impression that time is money and by answering your stupid questions you're standing in the way of them making it.
Leo
29th Jan 2020
1:38pm
Went to a skin Dr re a wart on my hand. He said it was ok and said can he look at my back. He did a biopsy and came back with a stage 1 melanoma . It was removed a few days later. After a recent unrelated surgery a biopsy showed cells were found to be dividing so precancerous.
I am glad these things were found
aussiecarer
29th Jan 2020
6:06pm
A friend of ours - his dad was a heavy smoker and he was told he had a cancerous spot on his lungs and he had to have surgery. He died of pneumonia in hospital while recovering from his lung cancer surgery. A few months later his mum was told she had breast cancer and she had chemotherapy and drugs to treat it. She was given the all clear but shortly after this she developed dementia and had to go and live in a nursing home where she died shortly afterwards from a fall. Months later their son happened to find his mum and dad's scans when he was cleaning out his parents belongings. He realised that the cancers on both his mum and dad's films were the identical shape. He thought that was freaky until he lined both the films up over the top of each other and discovered the "cancers" were in the same place on both films as well. He tried to make an appointment with the radiologist where his parents had got the scans but the specialists just fobbed him off and said he couldn't make inquiries because the patients were deceased. To this day he is convinced that both his parents were wrongfully diagnosed with cancer and that the treatment they had led to their early demise. Neither of his parents felt sick before their diagnosis of lung and breast cancer. The had just had "routine scans" because the GP said they were in high risk groups. The take home lesson - if a checkup shows you have cancer, get a second opinion and confirmation before submitting to surgery or chemotherapy
Pass the Ductape
29th Jan 2020
6:30pm
Now that IS scary!

Love to see the reaction on the face of a cancer specialist working in the public health system when you tell him/her you're intending to seek a second opinion though
MICK
29th Jan 2020
8:34pm
Prostate cancer kills more men than breast cancer does women but you never see that mentioned and it is never mentioned in the statistics. Why is that?????
Mariner
30th Jan 2020
10:27am
Maybe something to do with age, Mick. The boys get their cancer mostly later in life. I do know quite a few women with breast cancer in their 40s whereas the blokes I know with prostate cancer diagnosis are in their 60s plus. More shock value when the people affected are younger.
Old Fella
29th Jan 2020
9:25pm
For many a synonym for death is the word Cancer, and not without popular foundations. What is less so blindly accepted or known is the negative and sometime fatal result of Cancer treatment on otherwise healthy organs and human biology adjacent to cancers identified in the body. Perhaps patients could or should, be better informed and counselled to consider more thoroughly all consequences, when discussing with medical professionals Cancer treatment and potential outcomes. This is difficult, particularly for the patient, who in fear and speculation of their life are left to be the final arbitrator and judge on accepting or pursuing a specific treatment.
Old Fella
29th Jan 2020
9:25pm
For many a synonym for death is the word Cancer, and not without popular foundations. What is less so blindly accepted or known is the negative and sometime fatal result of Cancer treatment on otherwise healthy organs and human biology adjacent to cancers identified in the body. Perhaps patients could or should, be better informed and counselled to consider more thoroughly all consequences, when discussing with medical professionals Cancer treatment and potential outcomes. This is difficult, particularly for the patient, who in fear and speculation of their life are left to be the final arbitrator and judge on accepting or pursuing a specific treatment.
KB
7th Feb 2020
2:11pm
I have breast cancer which moved to the bones. Had surgery on my arm and hip. Surgery along with radiotherapy zapped out all the dead cells from surgery. In my case I would rather have tumours removed.
KB
7th Feb 2020
2:11pm
I have breast cancer which moved to the bones. Had surgery on my arm and hip. Surgery along with radiotherapy zapped out all the dead cells from surgery. In my case I would rather have tumours removed.


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