Early Detection: Is It Effective?

Thus far in class, we have discussed health promotion and disease prevention as two central goals of the Public Health field.  However, several Dartmouth researchers and doctors claim that early detection and screenings can lead to “overdiagnosis” and health issues that would have never occurred naturally.  With this conflicting message, I wonder- what is the best way to maximize health without causing harm?

One of the physicians, Dr. Welch, claims that a patient should be screened if he or she falls at the right spot on a “spectrum” between looking for early signs and already experiencing symptoms.  However, the doctor does not define the conditions that qualify a person to be classified as ready for testing.   Some tests can be expensive, invasive, and uncomfortable, but is it acceptable to put a limit on someone’s health and peace of mind?

Welch argues that doctors are overdiagnosing because they cannot identify who the people are that will never develop a life-threatening condition, so they treat everyone showing some abnormality.  Therefore, early detection is causing harm because even people who cannot “benefit” from treatment are receiving it.  Even if a disease is not life-threatening, it can still have a negative impact on an individual’s life and well-being.  Whether it is taking time off from work, not having enough energy to spend time with one’s kids, or having scars from a procedure, people can experience damage from diseases at all levels.  It is unethical to deny someone the opportunity to avoid these negative effects simply because he or she may not become deathly ill.

The Dartmouth crew does make a couple valid points.  For example, Dr. Welch says that some wellness programs have gotten away from educating people on healthy behaviors and how to manage their health.  Education is crucial to any wellness program.  If an individual does not know how to exercise properly or why eating vegetables, fruits, and whole grains is important to a healthy diet, he or she may be more reluctant to adopt and maintain these behaviors.  In this case, I agree with the researchers.

Overall, I do not understand how getting the recommended annual screenings for diseases like breast cancer could be seen as unnecessary.  Living a healthy lifestyle can prevent the onset of some diseases, but factors like genetics cannot be controlled.  Why risk waiting until it is too late and permanent damage has been done to be treated for a disease?  People deserve to be comfortable and confident that they are receiving the necessary care to keep them functioning at an optimal level.  Health promotion and disease prevention complement each other to create a well-rounded plan for keeping individuals and populations healthy.

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1 Comment

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One response to “Early Detection: Is It Effective?

  1. Leila Houshmand

    I would be interested to see the cost breakdown of how much money is saved doing preventative screening on those who may not develop the disease and doing preventative medicine with all of those people versus the treatment for those who do develop the disease when they were not offered preventative care. Personally, I believe screenings are a good thing and I would think that all of this preventative medicine would be more cost-effective that treatment. Also, I think the mental stress that would be added to people would be negative because they would be wondering what they might possibly have, when tests could give them peace of mind. The problems come when budgeting preventative screenings. Should everyone be entitled to these screenings and if not how do we choose? Back to the discussions we have had in class, preventative screenings would end up in a disadvantage for some, either those who could not afford it or those who it was not offered to. I do believe this is why such a study was conducted, but where we go from these results will be interesting.

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