If you want to get a better grasp on the intricacies of screenings and assessing their risk-benefit analysis, there’s now another option to reading about it. The inaugural episode of a new podcast series at HealthNewsReview.org features Hanna Bloomfield, M.D., M.P.H., sounding off on the problem of blanket promotion of cardiovascular screening and similar medical tests.
Screening tests, and the risk-benefit calculations associated with them, are among the most important areas of medical research for journalists to understand. Screenings aim to identify the likelihood that someone has a particular disease, but any such test also carries a risk of false positives that could lead to invasive procedures or other treatments that can cause harm.
This is especially (though not exclusively) true when it comes to cancer screenings. Controversy over the past several years about the usefulness of PSA tests for prostate cancer and mammograms for breast cancer have shown that the evidence does not always support universal screenings.
Yet public health campaigns have – at least until recently – rarely relied on the evidence to determine the utility or benefit of screening tests before recommending everyone get one. This has been changing, particularly with more attention paid to the recommendations of the U.S. Preventive Services Task Force. Yet it’s hard to break past the idea, both in the public health community and among consumers, that “more” is not “better” when it comes to looking for disease.
Perhaps counter intuitively, staying exceptionally vigilant for any hint of disease does not necessarily prevent deaths or even significant morbidity. How much harm can be caused and how much benefit can be gained by screenings depends on the screening test, its accuracy (including false positive rates) and the therapeutics actually available to treat the disease.
Recognition of this reality has led to more studies in recent years to actually assess the benefits and harms of screenings and try to determine whether the benefits outweigh the harms, and for which populations. This sorting through the many different screening tests for various conditions can be challenging to keep up with and confusing to the public – all the more reason for journalists to stay on top of it.
While some seasoned medical reporters may have become exhausted or jaded with the discussions over PSAs and mammograms, the potential harm of cardiovascular screening has not been in the spotlight as much, and there are many other tests whose ubiquitous use is equally concerning. At just under a half hour, the HealthNewsReview.org podcast is about the perfect length for an exercise regime or part of a work commute. Listen to Bloomfield talk about other potentially unnecessarily medical tests, such as female pelvic exams. See if the discussion doesn’t help frame the way you think about screening tests a little differently, and consequently report on them more critically.