Intended for healthcare professionals

Analysis

Why cancer screening has never been shown to “save lives”—and what we can do about it

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.h6080 (Published 06 January 2016) Cite this as: BMJ 2016;352:h6080

Including all mortality
Click here to see an infographic, explaining why reporting all causes of mortality in cancer screening trials is so important.

Shooting fish in a barrel: curing cancers that are clinically indolent

The absolute number of people dying from cancer in UK and Europe remained stubbornly stable over 40 years in spite of various medical interventions.(1).

It is a very remarkable coincidence that most of the 'extra' cancers diagnosed over the last 4 decades were indeed highly curable while the absolute number of cancer deaths has remained persistently stable across many well, developed countries over many decades. (1).

Over-diagnosis of 'indolent cancers' readily explains the paradox of increasing cancer incidence, better cancer survival rates but persistently stable , absolute, cancer deaths. (1). (2).

The routine and widespread use of CT, MRI and ultrasound scans has been responsible for this epidemic of over-diagnosis. Clinicians are curing cancers that do not need to be cured.

References:
1. Sundar S. Rapid response. Re:Median survival of cancer patients has risen from one to 10 years over past 40 years. http://www.bmj.com/content/348/bmj.g3011/rr/696834

2. Welch HG, Black WC. Overdiagnosis in cancer. J Natl Cancer Inst 2010;102:605–13. doi:10.1093/jnci/djq099

Competing interests: No competing interests

07 January 2016
S Sundar
Consultant Oncologist
Nottingham University Hospital NHS Trust
Nottingham