|
The assumption is that finding cancer early is always a good thing. Not so, said Dr. Virginia Moyer of the Baylor College of Medicine, who heads the [government] task force. [The test] only sometimes signals prostate cancer is brewing. It also can mean a benign enlarged prostate or an infection. Worse, screening often detects small tumors that will prove too slow-growing to be deadly. And there's no sure way to tell in advance who needs aggressive therapy. The task force analyzed ... whether routine screening reduces deaths from prostate cancer. The conclusion: There's little if any mortality benefit. But there is harm from routine screening: impotence, incontinence, infections, even death that can come from the biopsies, surgery and radiation, Moyer said.How might such a decision be made? Probably with a process not entirely unlike the following.1 (All numbers and test below are entirely fictitious.) Consider two medical tests, A and B for a particular type of cancer. Test A is 95% accurate at recognizing the cancer when it is present, but has a 10% false positive rate (indicating cancer is present when it is not). Test B is only 90% effective at detecting the cancer, and has a 5% false positive rate. The two tests use independent detection methods. Just one percent of men actually suffer from this cancer. Suppose a person is tested for the cancer using only one of the two possible tests, and that test comes back positive. Which test returning positive is more indicative of someone actually having the cancer?Associated Press, "Government panel recommends against routine PSA screening for prostate cancer," Washington Post, Thursday, 6 October 2011, http://www.washingtonpost.com/national/health-science/reports-say-government-to-recommend-against-routine-psa-screening-for-prostate-cancer/2011/10/06/gIQAPKCWRL_story.html
|