Amazingly, we treat too many women for breast cancer
WE treat too many women for breast cancer… Yes, yes, I know, this story is from the Mail where everything either causes or cures cancer. However, they are actually correct here:
About 4,000 women each year endure gruelling, unnecessary treatment for breast cancers that were not life-threatening, a review has found.
For every life saved by early detection, three women have therapy they do not need, according to the most definitive investigation of breast cancer screening so far.
Nearly all are given aggressive treatments – including chemotherapy, radiotherapy or having a breast removed – even though they might never have experienced any symptoms during their lifetime because their cancers were slow growing or non-aggressive.
The problem is that some to many cancers that we can detect never actually do become life threatening. This is even more true of prostate cancer: just about every man who reaches his 70s will have some indication of it and the vast majority die of something else before it even gets noted, let alone causes a problem.
What the Mail is pointing to is the way that this is to some extent true of breast cancer. What’s worse, we’ve not as yet any method of determining which of those found aren’t going to cause a problem and which will. Thus all found get that aggressive treatment.
There are those who argue, not quite successfully to my mind but it is close, that not actually checking men for prostate cancer at all would lead to longer and happier lives. For the treatments can cause so much pain and grief (and any treatment at all has the possibility of causing illness in and of itself), they’re so overused compared to the number who would actually die from the disease, that not doing anything to anyone might be better.
This isn’t true of breast cancer, at least not so far as we know.
However, here’s where the real problem comes in. Discussing this sort of thing requires detailed statistical knowledge. The sort of ability to understand and calculate the impacts of false positives, false negatives and so on. Skills which are in pretty short supply among doctors in fact. And as to the politicians who really determine who gets what: a test was done recently on some MPs. Only 25% of them could calculate the odds of getting two heads in a row on a pair of coin flips.
We’re doomed I tell you, doomed.