The month of May is designated for heightened awareness of multiple types of cancers. The principle behind cancer awareness is to make the public aware of specific symptoms that may warrant targeted medical evaluations. And to emphasise about cancer screening tests that are aimed at early detection of cancer, with prompt treatment that may enhance chances of cure. 

Many cancers present themselves through screening and early detection. Examples include breast cancer, prostate cancer, cervical cancer, colon cancer and many more. Cancer specialists in conjunction with public health authorities, usually provide scientifically sound guidelines on cancer screening strategies. Such guidelines include specific age groups and testing modalities (think imaging, blood tests and biopsies). Crucially, cancer screening guidelines also advise against testing in specific circumstances. 

But when you enter the real world of cancer screening, you may be in for a shocker. A recent research paper has brought to the fore grave discrepancies that exist between scientific recommendations for cancer screening and real practice within healthcare institutions. And this discrepancy has nothing to do with not getting optimal screening. It’s all to do with getting too much screening unnecessarily. 

What they recommended for cancer screening was compared against what is referred to as the gold-standard scientific recommendations. And what were the findings? These elite cancer centres recommended cancer screening tests outside of recommended age groups, did multiple combinations of unnecessary tests, and even offered executive evaluations, including cancer tests costing up to Sh1.3 million (US$10,000)! 

But what’s the matter with such a kind of testing? Too much screening comes with potential harms. You will get over-diagnosed, over-evaluated and over-treated. You will end up with psychological trauma, expensive bills and for some, life-changing medical harm, all occasioned by unwarranted cancer screening. 

But why would top cancer centres even consider screening patients for cancer unnecessarily? There are two sides to the coin here. Patients have become increasingly demanding of medical interventions. It is well known that patients overestimate the benefits of too much medical testing. Top cancer centres, and indeed all medical institutions, should not perpetuate such misunderstandings. But medical institutions have a conflict of interest at play. More screening leads to additional tests, more medical procedures and interventions, and more revenue. Cancer is a dreadful disease, but most of us will be taken out by something else. Don’t get paranoid and subject yourself to unnecessary testing by those concentrating on their bottom lines. 

Dr Murage is a Consultant Gynaecologist and Fertility Specialist.