Screening for cancer is like fishing for walleye.
If you have the resources, you can buy a good fish-finder to see where the fish might be.
When the finder indicates that there are fish down below your boat or ice-house,
you know there might be walleye, but they also could be carp, northern, or weeds, and not walleye.
If you decide to drop your hook, sometimes you catch a big one.
Okay, this is not a perfect metaphor, but screening for cancer often requires
advanced and expensive technology which is not always accurate.
Sometimes you find nothing, and sometimes you find a dangerous cancer that can be treated.
Screening for cancer is when there are no symptoms.
This is different than when cancer is discovered because of symptoms,
like when lung cancer induces coughing with bloody sputum,
or colon cancer causes blood in the stool, for example.
Examples of screening would include yearly low-dose CT lung scans in 55 to 85-year-olds
who have smoked a pack for 30 or more years, or colonoscopy every 10 years in people 50 or older.
Experts measure the value of screening in several ways.
First, what are the costs of the test and the costs of any further treatment that might follow.
'Costs' should mean the financial cost to patients, to insurance companies, or to the government,
but measuring costs should also include pain and emotional suffering to patients that may result from testing.
A second way to measure value for screening comes from measuring how sensitive the test may be.
If it isn't sensitive enough, then it will miss cancers.
If it is too sensitive, then it will indicate cancer even when there is no cancer
or no danger from harm by tumor or cancer.
A third issue is the age and wellbeing of the patient being tested.
If the individual is very elderly or ill, screening may be inappropriate.
The point is that while screening can be life saving, it is NOT always a good idea.
So, after doing you own research on the topic, when asking your physician or care provider about a screening test,
realize the complexity of this issue, and please depend on the wisdom and experience of your care provider.
These are complicated waters and we all could use a good fishing guide.
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