Consumer Reports’ Ratings of Eleven Cancer Screenings Include Eight Most Should Avoid

Report shines a light on hyped screenings that confuse rather than clarify
  
YONKERS, NY — In its March issue, Consumer Reports shines a light on oversold cancer screenings that might confuse rather than clarify.  The report evaluates eleven cancer screenings, finding that eight should be avoided. 

The report, available online at www.ConsumerReports.org and wherever magazines are sold, notes that the Ratings are for people who are not at high risk and without signs or symptoms of cancer.   

Screening tests for cervical, colon, and breast cancers are the most effective tests available, according to Consumer Reports’ first Ratings of cancer-screening tests.  But most people shouldn’t waste their time on screenings for bladder, lung, oral, ovarian, prostate, pancreatic, skin, and testicular cancers.  The Ratings are based mainly on evidence-based reviews from the U.S. Preventive Services Task Force, an independent group supported by the Department of Health and Human Services.   

“We know from our surveys that consumers approach screenings with an ‘I have nothing to lose’ attitude, which couldn’t be further from the truth.  Unfortunately some health organizations have promulgated this belief, inflating the benefits of cancer screenings while minimizing the harm they can do,” said John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center.  “To help clarify when most consumers should use cancer screenings and when they should skip them, we rate each screening and whether it is useful for a specific age group.  We also try to identify some high risk factors that may make screening a reasonable choice.” 

According to Santa, research suggests that even doctors don’t always agree on which screenings are necessary.  In fact, when Consumer Reports sought information on the percentages of patients who are screened for colon-cancer, it found striking variations in the states of Massachusetts, Minnesota, and Wisconsin.   In the state of Massachusetts, for example, where there are 150 medical groups, the lowest group rate for colon-cancer screening was 47% while the highest was just about double that figure (95%).  

Get These Screenings

Consumer Reports recommends three screenings.  The highlights below represent a brief synopsis; more details are available in the report.

• The screening for cervical cancer gets Consumer Reports’ highest score, and is recommended for women age 21-65. Women under 21 should skip the screening, a Pap smear, because the cancer is uncommon before then and the tests are not accurate for this age group. 

• The screenings for colon cancer get CR’s top score for people ages 50-75.  However, screening is less valuable for people 76-85.  Colon cancer screening receives a low score for people 86 and older and the lowest possible score for people 49 and younger.  Younger people should consider testing only if they are at high risk because the cancer is uncommon before age 50.

• The screening for breast cancer gets CR’s second highest score for women 50-74.  But women in their 40s or those 75 and older should talk with their doctor to see whether the benefits outweigh the harm based on their risk factors.

Avoid these screenings

Consumer Reports highlights eight cancer screenings that people at low risk should avoid, including the following three screenings which received CR’s lowest Rating.  More Ratings and greater detail, such as which individuals are at high risk and might need a given test, are available in the report.

• The screening for ovarian cancer gets CR’s lowest Rating for women of all ages, because the screening tests are not very effective.  Women don’t need to be tested unless they are at high risk. There are two tests: a transvaginal ultrasound or the CA-125 blood test, which measures a protein possibly associated with ovarian cancer.  

• The screening for pancreatic cancer gets CR’s lowest Rating for adults of all ages. People don’t need the test (genetic tests or imaging tests of the abdomen) unless they are at high risk, because no test is likely to detect the disease at a curable stage.

• The screening for testicular cancer gets CR’s lowest Rating for men of all ages.  Most men don’t need the screening, a physical exam, unless they are at high risk, because most cancers found without screening are curable. 

Questions you should ask

Consumer Reports recommends that patients ask their doctors a series of questions before undergoing any cancer screening, such as the following:  If the test results are positive, will it save my life?  Am I at higher risk for cancer than the average person, and if so, why?  How often does it provide falsely reassuring results?  Are any other tests just as good? And, if the results are positive, what’s next?