An interesting bioethics debate

Does early detection work? __The New York Times__ today posts a linkurl:story about Claudia Henschke,;http://www.nytimes.com/2006/10/31/health/31prof.html a radiology professor at Weill Cornell Medical College who?s pushing for routine CT scans to detect lung cancer earlier. The phrases are so well trodden, they?re often taken at face value: ?We?re lucky we caught it in time,? or ?If only we?d found it sooner.? The problem with simply accepting that earlier detection means better survival i

By | October 31, 2006

Does early detection work? __The New York Times__ today posts a linkurl:story about Claudia Henschke,;http://www.nytimes.com/2006/10/31/health/31prof.html a radiology professor at Weill Cornell Medical College who?s pushing for routine CT scans to detect lung cancer earlier. The phrases are so well trodden, they?re often taken at face value: ?We?re lucky we caught it in time,? or ?If only we?d found it sooner.? The problem with simply accepting that earlier detection means better survival is that it?s largely just an assumption. Yes, evidence strongly suggests that colonoscopy prevents death from colon cancer. But colon cancer and lung cancer are different. All cancers are different. To make a recommendation of routine screening, surely there should be some data showing that it doesn?t 1) raise false alarms over small but benign tumors or 2) miss fast growing, aggressive tumors that may be responsible for most cancer deaths. We?ll have more on this in November as Emanuel Petricoin and Lance Liotta square off against Barnett Kramer on using proteomics as a method for early detection. The Times? wrote a linkurl:front page story;http://www.nytimes.com/2006/10/26/health/26lung.html on Henschke?s recent uncontrolled study in __New England Journal of Medicine__ just last week. Today?s story paints Henschke as a bit of a maverick and details her frustration with what the writer calls a wet blanket statement from the ACS and the NCI: ?needs more research.? Would a controlled study limit access to a lifesaving technique? Would the technique even be cutting edge at the end of the study? Would it merely result in more dangerous surgeries and biopsies for harmless tumors. It?s an interesting debate on the nature of scientific research, and its gold standard to test every hypothesis, meeting head on with medicines? do-no-harm tenet.

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