This semester I’m taking a course in the Epidemiology and Prevention of Chronic Disease. Most recently, we’ve been talking about cancer and, more specifically, about screening for cancer.

As you may or may not be aware, the U.S. Preventive Services Task Force came out with some pretty controversial guidelines for breast cancer screening at the end of last year. Instead of the previous standard-of-care yearly mammogram after age 40, the USPSTF now recommends beginning screening at age 50 and only getting screened every other year. This caused quite a stir in the medical community and is the topic of today’s Public Health Grand Rounds. At this talk, Professor Ruth Kouides, MD is going to talk about what the evidence shows for breast cancer screening.

Unfortunately, what I’m learning is that, for many cancers, the current screening available really isn’t all that it’s cracked up to be. A lot of uncertainties remain from the various clinical trials testing the benefits and harms of screening for cancer. The problem is that, for diseases like prostate cancer and breast cancer, tumors may manifest that never would have caused any harm to an individual in the first place. By detecting these tumors through screening the problem of “overdiagnosis” arises. Patients are going through unnecessary treatments that may actually cause more harm than good — if not physically, then mentally. Also, the data are still unclear as to whether screening for breast cancer and prostate cancer is actually reducing cancer mortality.

Although there is concern about the effectiveness of some cancer screening, it is not fair to say that no screening should be done. For some people who are known to be at very high risk of cancer, screening is essential so that the tumor can be found at an earlier, less malignant stage. Also, screenings for other cancers, such as colonoscopies, have been very beneficial in preventing onset of disease or catching the tumor at a very manageable state.

Obviously, there is still a lot to be learned and discovered about cancer screening — if you’re interested in cancer, a large and diverse career path awaits you!