Low-risk growths in the breast, prostate and elsewhere should no longer be identified as cancer and screening efforts to spot them should be reduced, a panel convened by the U.S. National Cancer Institute said Monday.
A three-decade-long emphasis on the early identification of tumors was based on the idea that cancerous cells always spread and eventually kill, the researchers said in the Journal of the American Medical Association.
Instead of sparking a drop in the number of cancer deaths, the researchers said, the approach has led to the detection and toxic treatment of millions who may have never had any symptoms from indolent lesions.
"The goal going forward is to personalize screening strategies, and focus screening policies on the conditions that are most likely to result in aggressive illness and death," said Laura Esserman, director of breast care at the University of California, San Francisco's cancer center. "By recognizing that cancer is not one disease, but a number of different diseases, we can individualize our treatment."
The group led by Esserman said that doctors and patients need to realize that over-diagnosis and excess treatment is common and screening exacerbates the problem. Steps should be taken to reduce the risk, such as cutting the frequency of screening and its use in people who probably won't get the disease, they said.
The bar also should be raised for repeat tests and biopsies, they said.
They called for an independent, broad group under the auspice of a group such as the Institute of Medicine of the National Academies to review and rename less-risky lesions and growths currently identified as cancer. -- Bloomberg News