The Mental Health Impact of Cancer Screening

Cancer is a terrible disease called the emperor of all diseases.Although treatments have improved in recent years, a full understanding of its cause and optimal treatment remains elusive. It is still the second leading cause of death in the United States.

To prevent cancer deaths, many countries have for decades deployed screening programs that look for signs of cancer across the population, usually in age/sex cohorts. Logically, even if there is no cure for a particular type of cancer, if you don’t know it exists, you can’t hope to cure it. It will make treatment easier.

However, there is evidence to suggest that casting such wide nets across the population carries considerable risks, especially as it affects human psychology and, in turn, our overall health. increasing.

Vinay Prasad, an oncologist and researcher at Oregon Health and Science University, argues in numerous papers that screening can do as much harm as good at the population level. As Prasad showed, screening appears to have some benefit in terms of preventing death from the cancers for which it is screened, such as prostate cancer. When a large sample of people screened for prostate cancer is compared to a sample of people who were not screened, screened people are less likely to die from prostate cancer. The overall risk of death from all causes is about the same regardless of whether you have it or not.

Prasad’s analysis is based on large, rigorous, national studies of screening outcomes in the United States and Europe, including samples of thousands to hundreds of thousands of people. In many cases, Prasad found that the value of screening in reducing overall mortality risk is controversial at best.

This general pattern also appears to apply to common cancers such as lung, prostate, and breast cancer. Prasad suggests that the benefit of screening in preventing some cancer deaths is almost completely offset by the deaths caused by the screening itself, either directly or indirectly. For this reason, some screened people appear to be dying of conditions other than the cancer they were screened for, conditions they might otherwise not have. These findings call into question the value of current screening he programs, as the goal of public health is to reduce overall risk rather than specific risks.

The direct risks of screening have long been recognized, especially for tests that involve biopsy (removal of a small piece of tissue) or radiation (chest x-ray).But the most attractive—and annoying—possible indirect effects. This is where psychology comes into play.

A 2009 study by researchers at Harvard Medical School examined the causes of death in more than 342,000 men diagnosed with prostate cancer. They found that compared with the general US male population, cancer patients were significantly more likely to die by suicide or heart attack. It means that the diagnosis itself may prove fatal, even if the cancer itself is not.

This is probably understandable. For me, or anyone who has never been diagnosed with cancer, it is impossible to imagine the pain a diagnosis can bring. is. It makes sense that getting a diagnosis would cause psychological damage, which could be fatal.

Emotional distress can increase the risk of suicide. Stress can increase your risk of heart attack. Although adulthood stress has less causal effect on heart attack risk than childhood trauma and other factors such as smoking and cholesterol, adult stress now contributes to heart attack risk. The stress of diagnosis (and treatment) may itself be a sufficient stressor, or it may exacerbate other risk factors.

Because most people with prostate cancer die from other causes, this study suggests that some people may be better off not knowing whether they have prostate cancer. (However, since we are talking about population levels, it is difficult to know who will benefit and who will not). It is also possible that a small but significant number of diagnoses are false-positives in which cancer is not actually present. Prasad suggests that economic incentives may inherently push medical practice toward more screening, to keep expensive equipment such as CT scanners from being used infrequently.—However, this can cost the health of the population as a whole.

However, a caveat should also be noted. First, the studies discussed here relate only to routine screening programs deployed in large populations and included people who already had signs and symptoms of cancer. Not related to cancer testing. If you think growths, unusual sensations, or pain may be cancer, be sure to see your doctor to determine if you should get tested. I would like to emphasize that it is necessary to

Instead, the risk of screening seems to lie in its promiscuous nature. One of his recommendations for Prasad is to make screenings more targeted. National health authorities are already moving in this direction, but more specifics may be needed.

Second, these results are purely correlated and work at the population level. We do not know whether additional suicides and heart attacks after prostate screening were an unavoidable risk of screening. Other uncontrolled factors may have played a role. Prasad advocates much larger population studies to determine more accurate estimates of overall risk for screening programs.

But at least this area of ​​research and discussion serves as a reminder of how important our mental health is to our overall health. Illness can have a huge impact on our minds and, in turn, on our overall health. This could lead to better approaches to combating cancer.

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