Cancer tests can save lives, but can also have unintended effects

BOSTON, MA — In the case of most cancers, early detection increases the likelihood of successful treatment. However, looking for cancer in a man who appears to be healthy can have unintended consequences, says the October issue of the Harvard Men's Health Watch.

Most people realize that such tests may be frightening, inconvenient, or uncomfortable—and that invasive tests may have side effects that can be serious. But, says the Harvard Men's Health Watch, even a test that's safe and simple can lead to additional tests or treatments that are not. In short, the test can end up doing more harm than good.

Screening for colon cancer makes sense because the disease develops slowly in a predictable pattern and early treatment is highly effective but late treatment is not. Tests include fecal occult blood testing (FOBT), sigmoidoscopy, colonoscopy, and double-contrast barium enema. Skin cancer screening is easy, safe, and effective. By comparison, screening for lung cancer is more controversial. Spiral computed tomography can pick up cancers in the lung that are small, when they may still be cured, but it also detects many tiny nodules that are not malignant. Clinical trials are underway to determine if this test does more harm than good. At present, the American Cancer Society does not recommend lung cancer screening, even in smokers.

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