Our Center has its roots in the Veteran’s Administration (VA) Outcomes Group , something we founded in the 1990’s to look beyond the claims of modern medicine to what patients were really getting from the health care system.  Over the years, the Outcomes Group has published research questioning the benefits of screening for prostate, breast, and other cancers.  We have analyzed the “rates” of disease, often finding that what are reported as growth in incidence of disease is often a result of more aggressive screening, not necessarily an increase in health conditions that would cause harm or require intervention.

We are grateful to the ongoing funding support of the VA and particularly our colleagues at the White River Junction VA Hospital, who have made much of our work and research possible.

“Overstating the Evidence for Lung Cancer Screening”

Last year, the New England Journal of Medicine ran a lead article reporting that patients with lung cancer had a 10-year survival approaching 90% if detected by screening spiral computed tomography. The publication garnered considerable media attention, and some felt that its findings provided a persuasive case for the immediate initiation of lung cancer screening. We strongly disagree. In this article, we highlight 4 reasons why the publication does not make a persuasive case for screening: the study had no control group, it lacked an unbiased outcome measure, it did not consider what is already known about this topic from previous studies, and it did not address the harms of screening.  We conclude with 2 fundamental principles that physicians should remember when thinking about screening:

• survival is always prolonged by early detection, even when deaths are not delayed nor any lives saved, and
• randomized trials are the only way to reliably determine whether screening does more good than harm.

Pictured above from left to right:
Steve Woloshin, Gil Welch,
Lisa Schwartz, Robin Larson
"We promote what we call 'healthy skepticism' about medical procedures, diagnoses and treatments.  That means looking beyond the hype of claims that often use fear or exaggeration to influence patients and the public.”