Cancer Complexity

Lately I've been reading a lot of articles complicating the idea that finding cancer early is always a good thing. For example, I just read this NPR article about a Norwegian study that found that mammography can lead to the "over-diagnosis" of breast cancer by finding a tumor "that would never have gone on to cause symptoms or death." This is somewhat similar to some of the criticisms of the P.S.A. test for prostate cancer, which caused a lot of men to get treated for prostate cancer when they likely would have died of something else before the prostate cancer caused any problems.

It seems like the critiques of these screening tests go beyond whether or not the screening tests have high enough specificity and sensitivity (both concepts I first learned about in an epidemiology class here!), and have more to do with the nature of the cancers themselves. It's an interesting idea to me that may be some types of cancers aren't as well-suited for a screening test, since finding them early doesn't lower mortality. Apparently that's the cause with testicular cancer, which, according to the Mayo Clinic, is "highly treatable at all stages, so finding testicular cancer early doesn't make a cure more likely." Judging from this new Norwegian study and from other recent studies, it sounds like with breast cancer, there may some types of breast cancer that are good to find early while there are a few types of breast cancer that might not have the same benefits to being found early.

All of this adds a lot of complexity to an already complicated health problem. The fact that even within a kind of cancer there may be some types that benefit to screening while other types don't is really complicated to communicate to patients. I think generally speaking it's still very much agreed that the mammography, the Pap test, and the various kinds of colorectal cancer screening tests are still good and important to do. One harm of these findings is that it may lead people to not get screening tests done, since they figure "What's the point?", when in reality these screening tests still save lives.

Anyway, that's just been on my brain lately!

I should also note that April is Sexual Assault Awareness Month and there are a lot of great events coming up if you're in the Iowa City area. I know I'll definitely be going to the Take Back the Night rally and the Clothesline Project.

And this is an article my friend showed me that I read recently that was interesting: White Until Proven Black: Imagining Race in the Hunger Games - Anna Holmes, The New Yorker
This doesn't have to do with health; it's about race in books (specifically the Hunger Games but it branches out from there). I'm a fan of the Hunger Games and was really disturbed by some of the racist responses to the casting in the movie and I thought this article explored what those responses mean.