False-positives from cat scans for lung cancer could do more harm than good.
At least that's the conclusion of two cardiologists at the University of California, San Francisco.
The two — Dr. Rita Redberg and Dr. Sanket Dhruva — published their view in a recent op-ed in the San Francisco Chronicle.
Their piece notes that while "more Americans are worried about cancer than Covid-19, according to a recent Gallup poll," the screenings often lead "to significant harm."
|Dr. Rita Redberg|
On the other hand, cat scans might save a patient from lung cancer, which is now the leading cause of cancer death in the United States (130,000 people die from it each year).
The U.S. Preventive Services Task Force has recommended an annual CT scan for some patients with a heavy smoking history after shared decision-making — because it's been proven in clinical trials that it reduces the death rate when "performed on patients at high-risk — those age 50 to 74 who smoked about one pack per day for 30 years."
The Medicare Evidence Development and Coverage Advisory Committee, which Redberg has chaired and which is made up of independent experts, concluded, according to the op-ed, "there was not sufficient evidence that the benefits of a robust CT scan policy exceeded the harms."
The op-ed further maintains "research shows that shared decision-making is rarely happening prior to CT scans, despite the Medicare requirement. When any conversation does occur, doctors underemphasize, or omit altogether, the risks — while overemphasizing the benefits. Medicare has failed to enforce its own shared decision-making requirement, meaning that hundreds of thousands of patients are agreeing to lung cancer screening scans without being fully informed of the risks and shortcomings of the test."
|Dr. Sanket Dhruva|
Doctors "owe it to patients," they conclude, "to equip them with the information and tools to make fully informed decisions."More information about tests that can be risky can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.