Chlamydia, gonorrhea and syphilis on the rise: Is Tinder to blame?
screening
Breaking the silence: Should health workers ask about domestic violence?
In an emergency department in Calgary, a woman says she slipped on the ice, but her injuries don’t match a fall. In a private setting, the nurse begins to talk to her about domestic violence. Initially, the patient insists that she slipped, but after a long conversation, the nurse and the patient call the police together. …
Can a botched biopsy spread skin cancer?
Why unnecessary medical tests are bad for patients
Paternalism to patient-centered: do people want to know incidental findings?
A recent article in Healthy Debate highlighted the possibility of uncovering incidental findings as a significant challenge in genomic sequencing. An incidental finding is a genetic condition that causes a disease unrelated to the reason genetic testing was initially ordered. For example, imagine you have been recently diagnosed with a serious disease, such as colon …
Early stage breast cancer can be cured in most women
Ovarian cancer: why does it often evade early detection?
Evidence does not support blanket prostate cancer testing recommendation
Earlier this week, Prostate Cancer Canada released a recommendation that all men have a baseline PSA test in their 40s. This recommendation is based in part on a recent paper by Vickers and colleagues in the British Medical Journal that showed that men in their 40s with a relatively high PSA level have a higher-than-average …
We should aggressively screen for cancers early… right?
How can the idea of early detection and screening for cancers even be a debate? What could possibly be the downside of catching cancers early, and treating them before they cause great harm, even death? Logic says if you can’t prevent a cancer in the first place, then diagnose it as early as you can, …
Pap smears: paranoia or peace of mind?
The thought of the annual Pap smear causes me as much discomfort as it does any young woman. When I read the new guidelines for cervical cancer screening in Ontario, reported in last month’s issue of Journal of Obstetrics and Gynaecology of Canada, I was slightly relieved at the recommendations being put forth. Rather than …
Weighing the harms and benefits of mammography
Healthydebate.ca has run a series of stories on breast cancer screening mammography, stimulated by the recent guidelines from the Canadian Task Force on Preventive Health Care. This last story focuses on how women and policy makers must balance the benefits and harms of screening mammography. The issues raised in this series are relevant to screening …
Did mammography save her life?
Some breast cancers detected by screening mammography are cured and would have led to death had they not been detected early. Other breast cancers detected by screening can be treated just as effectively if diagnosed later, may not have needed treatment at all, or may be so advanced that treatment does not prevent death from …
Screening mammography
As a rural family doctor I have to factor in travel costs when referring my patients for specialized services. Costs of travel include not only transportation expenses but time from work and home. Increasingly patients are being forced to travel again and again after having tests. A good example is breast screening which causes many …
Interpreting randomized trial evidence around mammography
The Canadian Task Force on Preventive Health Care recently released recommendations about screening for breast cancer. These recommendations have been criticized by some because they emphasize the results of randomized trials. This article explores the advantages and limitations of randomized trial evidence regarding screening mammography. The recent recommendations by the Canadian Task Force on Preventive …
Presenting the benefits of mammography
The results of research on screening for breast cancer with mammography can be presented in ways that make the benefits seem larger or smaller Similarly, the benefits can be described as avoiding deaths from breast cancer or avoiding deaths from any cause Part of the debate about the benefits of screening mammography may be related …
The mammography controversy
In medical journals, doctors and scientists continue to debate the relative benefits and harms of breast cancer screening for women who are at average risk of developing breast cancer. This debate is not always reflected in screening programs, most of which strongly recommend mammography to average risk women within a certain age bracket. Some experts …