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Overdiagnosis and Overtreatment in Cancer
Journal of American Medical Association ^ | Jluy 29, 2013 | Laura J. Esserman, MD, MBA1; Ian M. Thompson, Jr, MD2; Brian Reid, MD, PhD3

Posted on 08/04/2013 8:07:43 AM PDT by Innovative

Optimal screening frequency depends on the cancer's growth rate. If a cancer is fast growing, screening is rarely effective. If a cancer is slow growing but progressive, with a long latency and a precancerous lesion (eg, colonic polyps or cervical intraepithelial neoplasia), screening is ideal and less frequent screening (eg, 10 years for colonoscopy) may be effective. In the case of an indolent tumor, detection is potentially harmful because it can result in overtreatment. These observations provide an opportunity to refocus screening on reducing disease morbidity and mortality and lower the burden of cancer screening and treatments.

In March 2012, the National Cancer Institute convened a meeting to evaluate the problem of "overdiagnosis," which occurs when tumors are detected that, if left unattended, would not become clinically apparent or cause death. Overdiagnosis, if not recognized, generally leads to overtreatment

(Excerpt) Read more at jama.jamanetwork.com ...


TOPICS: Health/Medicine; Science
KEYWORDS: cancer; cancerscreening; deathpanels; medicalcare; nochemo4you; obamacare; obamacaredeathpanels; overdiagnosis
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To: Innovative
I am very wary of these studies that talk about over diagnosis and over treatment of cancer especially when the recommendations go against long established medical protocols by cancer experts. Bean counters will talk about "statistically insignificant" differences, but that means that some people will not get treated and likely die of their cancer because they are in that statistically insignificant outlier.

Breast cancer survival in the UK versus the US is a perfect example how the bean counter methods are costing lives. The five-year survival rates for all forms of breast cancer - including the most advanced - stand at 85 per cent in the U.S and just under 74 per cent in the UK. If the cancer is caught early - at what doctors call stage 1 - the differences in survival are even more shocking. An American woman has a 97 per cent chance of being alive five years after diagnosis. In Britain, this figure is only 78 per cent. Routine breast screening in the U.S. starts at 40 rather than 50, as in Britain, and women are thoroughly checked every one to two years, rather than every three years under the NHS. link to article

Note that some nameless study group funded under Obamacare has already said that women do not need mammograms every year and that doing them every two or three years and starting at age 50 has a statistically insignificant difference in survival rates.

21 posted on 08/04/2013 8:52:57 AM PDT by The Great RJ
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To: goodwithagun
N0. You might be on to something. We tend to live a pretty sterile life these days.

Much of what we eat is highly purified. Only recently have doctors taken probiotics more seriously. I know. I have digestive issues.

Weight might play a part. Also, a certain level of natural stress in the body is good. Stress in the form of lack of food and necessary physical exertion. Those stresses can cause a defensive reaction in the body and that reaction might prevent cell DNA damage and maybe even Cancer.

22 posted on 08/04/2013 8:54:23 AM PDT by dhs12345
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To: ChildOfThe60s

“Generally, that can be determined by the analysis of the cancer cells.”

And how do you propose to analyze the cancer cells, if early detection and screening is not available, so people don’t even know whether or not they do have cancer, until it’s progressed? This is what is being advocated here.


23 posted on 08/04/2013 9:14:41 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: cornfedcowboy

“Cancer is an incredibly complicated thing.”

I think this is one thing we can all definitely agree on.


24 posted on 08/04/2013 9:16:34 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: Innovative

Looks to me like more set-up for the “death panels” to begin to do their grisly work. In re: “indolent tumor”, I’ve always thought “indolent” referred to lazy and unwilling to work folks, aka “democrats”. Had to check Websters’ dictionary to learn it also refers to “causing little or no pain”. With regard to their statement, “Thyroid cancers and melanoma are examples for which screening has expanded and, along with it, the detection of indolent disease”, it appears to me that if a cancer isn’t causing pain then a person is “good to go”. Come back and see the doctor when you have pain only to be told you are SOL. Have these paragons of healing ever heard of and practiced by the Hippocratic oath? A pox on all their houses. If my doctor had used this criteria, then I would not have returned to see him until long after my cancer had metastasized and spread throughout my body.

This crap is certainly Obama’s baby. These docs propose to redefine the terms just like Obama called the killing of 14 Americans by a Muslim terrorist at Ft. Hood “workplace violence” rather that an obvious terrorist attack by a jihadist. They propose saying a “cancer” is NOT actually “cancer” unless and until a person’s condition is “lethal” if left untreated and, apparently, in order to insure this outcome, they propose to reduce the number of screenings so that a cancerous condition won’t be found and in the event one is found, then said patients’ name is added to an “observational registries for low malignant potential lesions”.[the real SOL list] Translated: this means said unfortunate patient cannot receive treatment until said “cancer” (which hasn’t really existed up until this point) causes pain.

This is insanity.


25 posted on 08/04/2013 9:17:10 AM PDT by miele man
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To: miele man

You nailed it.

Welcome to Obamacare.


26 posted on 08/04/2013 9:19:45 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: Innovative
Hospitals and Oncologists:

"We are $o $orry. Plea$e $ubmit your in$urance card and we'll help make your la$t day$ of $urvival helli$h."

27 posted on 08/04/2013 9:21:25 AM PDT by USS Johnston (All that is necessary for the triumph of evil is that good men do nothing. ~ Edmund Burke)
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To: USS Johnston

Here is preview of things to come to the US under Obamacare:

UK hospitals face review criticism over death rates

http://www.france24.com/en/20130716-uk-hospitals-face-review-criticism-over-death-rates

“The report is likely to show that the scandal was not an isolated case, highlighting poor standards of care at a number of hospital trusts with higher-than-expected death rates.

Keogh’s investigation reportedly suggests there may have been up to 13,000 needless deaths in the 14 trusts since 2005.

Professor Sir Brian Jarman, an adviser to Keogh, said inadequate numbers of doctors and nurses was a major factor.”


28 posted on 08/04/2013 9:31:20 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: Innovative

Ya....we’re saving too many lives with early testing and treatment.

This costs way too much.

You have a “duty to die” you know......

This message brought to you by the secularist religion of “Dirt Good, People Bad”.


29 posted on 08/04/2013 9:33:22 AM PDT by G Larry (Let his days be few; and let another take his office. Psalms 109:8)
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To: dhs12345

We are huge probiotic fans! My ten year old nephew was recently diagnosed with bipolar disorder. He spent two weeks with us during which he had no fast food and very little processed food. His usual diet with mom is a bag of Doritos a day, a Pop Tart for breakfast, a Lunchable for lunch, and fast food or delivery for supper. His mom is a sunblock Nazi, so we gave him vitamin D pills in addition to krill oil, probiotics, and a high quality multivitamin. We also noticed that although he is obese he eats very little. We found a snack he would eat: Cashews. When he started having his “issues” we fed him these. I think his blood sugar just needed stabilized. My son has the same problem. Have you seen the Snickers commercial with Joe Pesci? That’s my son when he gets hungry. He’s so skinny but he constantly has to eat. I’m not denying that there are very serious medical issues with which medicine is truly needed; however, I also think that some people are their own crown of thorns when it comes to thier health.


30 posted on 08/04/2013 9:53:40 AM PDT by goodwithagun (My gun has killed fewer people than Ted Kennedy's car.)
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To: goodwithagun

If your nephew is obese and his mother is feeding him that crap, that’s abuse.

Just sayin’.


31 posted on 08/04/2013 9:55:43 AM PDT by Black Agnes
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To: Black Agnes

I couldn’t agree more. My argument with my in-laws is that if starving a child is abuse then so is this. His mom is a workout fanatic and his dad coaches football. Now tell me they don’t know what’s going on. The major problem is that my nephew, much like both of his parents, has never been told no. It was always easy just to give in to the temper tantrums. Spanking? How cruel and uncivilized (my husband, his uncle and godfather, spanks him and the parents don’t have top he nerve to say anything)! There are many issues here, including the fact that mom and dad are completely responsible for the potential ruination of a perfectly fine little boy.


32 posted on 08/04/2013 10:06:17 AM PDT by goodwithagun (My gun has killed fewer people than Ted Kennedy's car.)
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To: Innovative
But expect to see more and more of these articles, as Obamacare expands -- doctors and people need to be "educated" so they won't seek treatment, which cost money, of course, but go and die quietly.

Exactly right. We have been seeing more propaganda like this from the bureaucrats under HHS.

33 posted on 08/04/2013 10:09:45 AM PDT by FreeReign
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To: Innovative

Smoke and mirrors and political agenda, sum up the article, JAMA, and the NCI.

They are trying to nit pick at everything OTHER THAN their greed and the greed of “medical administrators” and medical professionals (doctors) *and* their lawyers ... almost none of whom imagine cutting their incredible income, relative to most people (with the exception of the incredibly greedy banksters *and* *THEIR* lawyers).

NONE of the above well-paid medical and “medical” types, imagines *THEIR* not getting the testing.

NONE of the major contributors to medical systems (and to “medical ‘systems’”) ... will tolerate a cut in *THEIR* testing.

How would the big shot “medical administrators” who are trying to focus upon everything EXCEPT THEIR PAY, like to fly around or drive around in vehicles that get the same kind of testing theory?

That’s it, we’ll just “reduce”/means:*stop* testing and redefine things.

A crack in aluminum, will now be ... a “pre-fissure” and not worth mentioning anywhere UNTIL AFTER THE CRASH! ... in some footnote that a relative finds some day.

That’s right, the argument against testing, is *NOT LOGIC,* but, “Hey, we need to cut costs, and we aren’t going to take a pay cut, so we’ll just cut something ... else ...”

That is important to somebody else, like you, like your family, like your kids.

Sure.

We came all this way, developing great tools ... only to retire them to some Museum of How Great Health Care Was ... no thanks, to all the greedy “medical administrators” and their “comfort zones” that outweigh medical care in our lives.

Not to mention all so many government types who ALSO will insist upon, and get, testing for *them and theirs* ... but not you.

The net of it all, will be a *medical/”medical”* class system: the haves and the have-nots.

Pretty quickly, we are already finding, that the government class and medical class are becoming one, “or else” under ObamaCare.

Leaving the rest-of-us class, to listen to the many hundreds of thousands of that system’s-insiders preaching about, as Diane Sawyer is want to: “There are all these ‘glass’ barriers ...”

We will have some sympathy and shoulder shrugs and boo-hoo faces of those talking heads of media, medicine, political-leftists, and government, all of whom, are *inside the comfort zone of their special health care system that is exempt from ObamaCare.*

While the parents of the children in the many childrens’ hospitals, will regard the article, the JAMA, and the NIC ... as NUTS!


34 posted on 08/04/2013 10:18:01 AM PDT by First_Salute (May God save our democratic-republican government, from a government by judiciary.)
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To: goodwithagun

Learning ‘No’ and ‘everyone’s different’ is a great lesson in childhood.

I learned that just because Sally Sue could eat Grandma’s home baked cookies by the handful didn’t mean I could. Unless I wanted to weigh 200lbs at 14. But that’s OK. I whupped little Sally Sue’s (little) behind on the SAT. Etc.

Learning to say NO to YOURSELF is the most critical lesson you’ll ever learn. And you never learn that one if you never hear it at all.

Hubby was the same way. We both agree that in spite of hating it at the time, having our moms ride our backs about food consumption and weight gain is the ONLY reason we’re not both 500lbs today.

Once this kid gets in the obese weight ‘hole’ that young, he’ll never be thin without surgery or massive intervention.

I hate to see it, frankly.

My kids aren’t allowed to eat Doritos. Or storebought poptarts. They split a 12oz ‘Simple Truth’ soda from Kroger roughly once a week for a treat. We have chickens so scrambled egg is a frequent snack. And veg or fruit from the garden. And, amazingly enough, nobody has had a cavity in 4 years now. Our pediatric dentist continues to be amazed.


35 posted on 08/04/2013 10:38:47 AM PDT by Black Agnes
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To: Black Agnes
We’ll let you wait out that suspicious lump in your junk then. I’m sure if you wait 6m it’ll be OK or just go away.

Oh, not I; I'll just go ahead and have my "junk" (what a pathetic term to describe the organs of generation) removed, without consulting a physician to see just what the suspicious lump is.

36 posted on 08/04/2013 11:32:04 AM PDT by Mr Ramsbotham (I'll retire to Bedlam.)
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To: Mr Ramsbotham

Sad thing is. Obamacare will pay for sterilization but likely not for having the lump checked...

And I apologize for calling it junk.

It’s the vernacular of an age demographic.


37 posted on 08/04/2013 11:36:03 AM PDT by Black Agnes
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To: Innovative
And how do you propose to analyze the cancer cells, if early detection and screening is not available, so people don’t even know whether or not they do have cancer, until it’s progressed? This is what is being advocated here.

If you go back and read what I wrote you will note that I agreed this is all smoke and mirrors to prepare us for rationing.

I'm simply stating that the aggressiveness of a particular type of cancer is generally able to be determined when the cells are analyzed. Often, the cancer's organ of origin is also determinable by the cells. i.e. breast cancer cells found in another location.

38 posted on 08/04/2013 11:54:57 AM PDT by ChildOfThe60s (If you can remember the 60s.....you weren't really there)
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To: Innovative

At 75, last time I went to the urologist he told me my PSA was fine, but at my age it really didn’t matter because anything he could do for me if cancer developed would probably do more harm than the cancer before I’d be dead anyway - very comforting (and a precursor to what we’ll be hearing more and more under Obamacare)......


39 posted on 08/04/2013 12:24:17 PM PDT by Intolerant in NJ
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To: goodwithagun
And vitamin D too! Cool. That is another one that people lack. Me included. Vit D is the wonder “drug” for me.

Considering what our parents and grand parents ate not too long ago and what people ate all the back to the beginning, one of the possible causes of recent health problems is sterile and excessively purified food.

Purified food is so broken down that it is too easily released into the system. And purified food lacks probiotics. And, penicillin can wipe out healthy bacteria. Always load up on probiotics when you are taking penicillin. A drink that we have found that works really well is Kefir.

http://www.lifeway.net/Probiotics/ It sold at our supermarket.

40 posted on 08/05/2013 10:56:45 AM PDT by dhs12345
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