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Recent Cancer Screening Changes Leave Many Confused
Date:11/24/2009

false-positive results, which lead to more biopsies and more angst. This is true of breast, cervical, prostate and other forms of cancer, experts concur.

"There's appropriate screening and there is the appropriate population that should be getting that screening, and there is the appropriate screening interval," said Dr. Otis Brawley, chief medical officer of the American Cancer Society. "We can violate all of those things."

Meanwhile, false-positive results from mammographies are more common in younger (age 40 to 49) women than in the upper age bracket. And the age cut-offs for screening may be artificial.

"We like to lump people into big decades of life, so the risk of a 40-year-old woman and the risk of a 49-year-old woman [for breast cancer] are different," Brooks noted. "The risk at 40 is much less than the risk at 49."

"Younger women are at higher rates of false-positives, which results in more biopsies, more procedures being done and women getting callbacks for extra mammograms," he added. "This creates anxiety for something that's not anything bad."

Also, there's increasing evidence that some cancers will never turn into anything dangerous and, therefore, don't warrant treatment.

"Our definition of cancer was given to us by German pathologists in the 1840s after they looked at biopsies from autopsy specimens," Brawley explained. "Now, 170 years later, we've progressed in terms of imaging, in terms of medical diagnostics into what I call the genetic and molecular biologic age, but our ability to define cancer has not progressed beyond the light microscope. What we need to be able to do eventually is say that 'this cancer is never going to progress,' it is not going to spread and invade other organs in the body. But right now we don't have the molecular tools to predict their behavior."

"Not only do we need to find small tumors, we need to know more about the biology of those tumors," added
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