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Most screening tests do not save lives, researchers argue

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h250 (Published 15 January 2015) Cite this as: BMJ 2015;350:h250

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In the case when patients are asymptomatic and under-checked by screening test, diseases have been detected earlier, the lead time increased, a 5 year survivor might be reached. However, it is apparent the patient has not derived any benefit from earlier detection in terms of having lived any longer; it is not because death has been delayed, but because the diagnosis has been made earlier (Gordis, 2014).

Even without any benefit in saving lives (Saquib, Saquib, & Ioannidis, 2015), the lead time associated with diagnosis being made at an earlier point in the natural history of the disease suggests a benefit in the form of enhanced survival. The possible explanations for no benefit of screening may be the natural history of the disease and the available treatments may not be more effective or inadequate (Gordis, 2014).

The earlier diagnosis might even cause some negative effects for untreatable diseases such as cancer and gene mutation related diseases, which include financial burden, anxiety, and emotional distress for patients and their family members.

References

Gordis, L. (2014). Epidemilogy (Fifth ed.). Philadelphia, PA 19103-2899: Elsevier Saunders.

Saquib, N., Saquib, J., & Ioannidis, J. P. (2015). Does screening for disease save lives in asymptomatic adults? Systematic review of meta-analyses and randomized trials. International journal of epidemiology, dyu140.

Competing interests: No competing interests

30 January 2015
Van Tuyen Duong
Scientific Researcher
Taipei Medical University
No 250, Wuxing Street, Taipei City, Taiwan, 110