Five year survival data mean nothing

Five year survival data mean nothing

I’ve been telling you for years that in order to make an informed decision, it’s important to discuss the pros and cons of treatment options with your physician. I made a special point of this when it came to breast and prostate cancer screening.

Well, it turns out when it comes to screening and cancer prevention conversations such as these may not be helpful at all. Most U.S. doctors fail to grasp simple statistics about cancer screening, which could boost their enthusiasm for unproven and potentially harmful tests, according to a new poll released this week in the Annals of Internal Medicine.

Three-quarters of the more than 400 doctors surveyed believed better survival rates prove screening is a lifesaver although that’s not the case. And nearly half thought early detection translates into saving lives — another common misperception.

The important information is whether the death rate improves by screening. For example, the five year survival rate for breast cancer has improved since mammography screening, but it’s benefit in improving the death rate from breast cancer is very small.

The reason is that screening automatically increases survival rates, because finding a tumor early means people live longer with their cancer diagnosis than if they had waited until they had symptoms to see a doctor — regardless of whether or not anything is done to treat them.

Doctors were three times more likely to recommend a test that increased the (irrelevant) five-year survival rates from 68 percent to 99 percent than to recommend a test that slashed the much more important death rate from 2 in 1,000 people to 1.6 in 1,000.

Until a solution is found, it is imperative to ask your doctor the right questions before consenting to any test:

What are the benefits of the test?

What are the potential harms from the test?

If the answer is the five year survival is increased, your doctor doesn’t know what he’s talking about.

 

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