[Press release] Equation helps identify global disparities in cancer screening and treatment | EurekAlert! Science News

Equation helps identify global disparities in cancer screening and treatment | EurekAlert! Science News.

From the 20 January 2015 press release

Disparities in cancer screening, incidence, treatment, and survival are worsening globally. In a new study on colorectal cancer, researchers found that the

Age-standardised death rates from Colon and rectum cancers by country (per 100,000 inhabitants). (Photo credit: Wikipedia)

mortality-to-incidence ratio (MIR) can help identify whether a country has a higher mortality than might be expected based on cancer incidence. Countries with lower-than-expected MIRs have strong national health systems characterized by formal colorectal cancer screening programs. Conversely, countries with higher-than-expected MIRs are more likely to lack such screening programs.

The findings suggest that the MIR has potential as an indicator of the long-term success of global cancer surveillance programs. “The MIR appears to be a promising method to help identify global populations at risk for screenable cancers. In this capacity, it is potentially a useful tool for monitoring an important cancer outcome that informs and improves health policy at a national and international level,” said Dr. Vasu Sunkara, lead author of the Cancerstudy. Senior author Dr. James Hébert, who had used the MIR previously at the state and national level within the US, added that the use of the MIR internationally opens new possibilities for testing the relationship between this important indicator of cancer outcome and characteristics of countries’ health care delivery systems.

 

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What Doctors Don’t Know & Journalists Don’t Convey About Screening May Harm Patients

From the 8 March 2012 blog item by Gary Schwitzerat at HeatlhNewsReview.org

A paper in the Annals of Internal Medicine this week asked (and partially answered): “Do Physicians Understand Cancer Screening Statistics?”

The authors – familiar names like Woloshin, Schwartz, Gigerenzer – are from the Harding Center for Risk Literacy at the Max Planck Institute for Human Development in Berlin and from the Dartmouth Institute for Health Policy and Clinical Practice.

It’s a shame this paper isn’t freely, publicly available to all readers because it may help explain some of the foundation of the dilemma we face in this country about miscommunication about the tradeoffs involved in screening tests.

Reuters Health reported:

“…three-quarters of the more than 400 doctors surveyed believed better survival rates prove screening is a lifesaver although that’s not the case, researchers say.

And nearly half thought early detection translates into saving lives — another common misperception.

“This is really unfortunate because one of the things we always say is, ‘Discuss it with your doctor,’” said Dr. Otis Brawley, chief medical officer of the American Cancer Society. “This is evidence that your doctor doesn’t know.”…

…

Dr. Steven Woloshin, of Dartmouth Medical School in Hanover, New Hampshire, who worked on the new survey…told Reuters Health that death rates gleaned from clinical trials are the only reliable way to judge if a screening test is effective. But organizations that promote screening, such as the breast cancer charity Susan G. Komen for the Cure, tend to prefer survival rates, which sound more impressive…

…

 Dr. Virginia Moyer of Baylor, also chair of the US Preventive Services Task Force, wrote an accompanying editorial, “What We Don’t Know Can Hurt Our Patients: Physician Innumeracy and Overuse of Screening Tests.“  In it, she mentioned our work:

“Excellent work on how to effectively communicate statistical data to both patients and physicians has been done, but more is needed. Work of this sort is being supported by the Agency for Healthcare Research and Quality and such groups as the Foundation for Informed Medical Decision Making. To temper the unbridled enthusiasm of patients for screening tests, and especially for cancer screening, we need to reach beyond medicine to the public, which of course gets a substantial amount of medical information from the media. Educational efforts should focus not just on medical students and physicians but also on journalists. Several medical journals have taken the lead in making it easier for journalists to get the statistics right and to recognize the limitations of the studies they report. Watchdog groups, such as HealthNewsReview.org, help to monitor press reports and should be encouraged to add interpretation of screening statistics to the criteria they use to assess health news stories.”…

 

Related articles

• Most U.S. Doctors Baffled by Cancer Screening Stats (nlm.nih.gov)
• Many Docs Order Unneeded Lung Cancer Screening Tests: Survey (news.health.com)
• Many Primary-Care Docs Don’t Understand Cancer-Screening Stats: Study (blogs.wsj.com)
• Ovarian Cancer Screening Popular Despite Guidelines (nlm.nih.gov)
• New Guidance For Colorectal Cancer Screening (medicalnewstoday.com)
• When Are You Too Old For Routine Screening Tests? (aarp.org)