Originally published November 10 2010
Dying cancer patients subjected to expensive, meaningless cancer screening tests
by S. L. Baker, features writer
(NaturalNews) Earlier this year, NaturalNews reported the kind of story that almost seems too far-fetched to be true. According to a study by University of California at San Francisco (UCSF) researchers that was published in the American Journal of Public Health, unneeded, expensive mammograms are regularly pushed on elderly women who are incapacitated and dying from Alzheimer's disease or other forms of dementia, especially if the patients still have assets of $100,000 or more (http://www.naturalnews.com/028095_mammograms...).
Think the cancer screening industry couldn't get any greedier than that example? Think again.
Another study, just out in the October 13 issue of the Journal of the American Medical Association (JAMA) concludes a sizeable proportion of terminally ill cancer patients are being subjected to common, expensive (and often painful) cancer screening tests. And these tests provide virtually no benefit whatsoever to those dying of cancer -- although they do hike up medical bills and profits for health care providers.
Yes, people with a very limited time to live are being given mammograms, Pap tests, colonoscopies and prostate-specific antigen (PSA) tests on a regular basis. It turns out, according to background information in the study, that current cancer industry screening guidelines fail to even address the appropriateness of these screenings for individuals with terminal illnesses.
"In the extreme situation of patients with advanced cancer, screening will lead to over diagnosis (detection of a cancer which, if not found by active search, would not affect survival) in virtually all cases when a new malignancy is found. In addition, patients may be subject to unnecessary risk due to subsequent testing, biopsies, and psychological distress," the authors stated.
Camelia S. Sima, M.D., M.S., of Memorial Sloan-Kettering Cancer Center, New York, and her research team investigated the extent to which patients with advanced cancer continue to undergo screening for new cancers by studying data on 87,736 fee-for-service Medicare enrollees ages 65 years or older. All had been diagnosed with advanced lung, colorectal, pancreatic, gastroesophageal, or breast cancer between 1998 and 2005. The research subjects were followed up until December 2007 or until they died, whichever came first.
The researchers found that after advanced cancer diagnosis, almost 9 percent of women were still being given at least one screening mammogram and almost 6 percent had Pap tests. Among men with advanced cancer, 15 percent were still being sent for PSA tests. For male and female patients following terminal cancer diagnosis, almost 2 percent were still being subjected to colonoscopies.
The strongest predictor of screening tests in people with advanced cancer was the fact they had already had screening tests before they were diagnosed with a terminal malignancy. So, the researchers stated in their study, their best explanation for the ordering of basically unnecessary, expensive tests is that patients and doctors are accustomed to obtaining cancer screenings at regular periods and just keep on continuing the tests ".. even when the benefits have been rendered futile in the face of competing risk from advanced cancer."
The study's conclusions mention little about how these tests add to the already sky high medical expenses associated with terminal cancer. However, they do mention that a policy change in Medicare payments for the screenings -- which would no doubt cut down on many of these unneeded tests -- would make sense. "... the Medicare program might not provide coverage for cancer screening procedures for patients with life expectancy of less than 2 years," the researchers wrote.
For more information:
http://www.ncbi.nlm.nih.gov/pubmed/20940384
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