Strong and Vital No 3

Breast cancer: When introducing a program for early detection of breast cancer, the current narrative pro mises: «It may be expected that the early detection program can reduce breast cancer mortality (...) by 15 to 20 percent». A villain who would not support this program! Up to 20 out of a hundred women can be spared death from cancer! What is the reality? According to a Cochrane Review (the gold standard of medical studies), out of a thousand women who participate in a screening pro gram, four die of breast cancer, five out of the non participating thousand. In absolute terms, therefore, as a result of the early detection program mortality is reduced by one woman in a thousand compared to the lack of screening, that is exactly one per thousand. Of course, you can put it another way: 4 are 20 per cent less than 5, and suddenly we have a relative 20 percent reduction in breast cancer deaths! This is the fraud that can be traced through the entire medical literature: instead of the absolute risk reduction (in our example 1 per mille), the relative risk reduction (in our example 20 percent) is used, and the result is not worth the candle. A huge success. But what the program then forgets to promise: How many of the thousands of women who participate in a screening program are startled by a false-positive result? And will further tests be necessary until the suspicion of breast cancer can be eliminated? No less than a hundred! So 10 percent of women are initially alarmed by a precautionary program until the suspi cion turns out to be invalid through further tests. Up to five out of a thousand women are even treated as «cancer patients» due to a misdiagnosis. With steel, blasting or chemo or a combination thereof.

rapy has become better, possibly less misdiagnosis is made thanks to artificial intelligence.

However, I am still waiting for proof that the benefits of breast cancer screening are greater than the damage. Prostate cancer screening is not different, according to the large ERSPC study, which was first published in 2009 in the New England Journal of Medicine and its continuation in 2014 in The Lancet . The prevention machine continues at full speed.

It could not keep its promise to spare unneces sary suffering and give us more healthy years of life. Quite the opposite.

During the thirteen years of regular screening, the mortality rate of prostate cancer was reduced by 1.28 per mille. Many of these thousands of regularly tested men had to undergo additional invasive test until the cancer diagnosis could be confirmed or (much more frequently) rejected. In addition, more men died in the screening group than in the comparison group without screening. A catastrophe that is sold as a success story. Primum non nocere or «The supreme principle of medical action is not to cause harm» is the best Hippocratic tradition and was formerly part of the Hip pocratic oath that physicians had to lay down. Every doctor certainly knows this sentence, he usually only forgets that it is also valid for his actions. The prevention machine continues at full speed. It could not keep its promise to spare unnecessary suffering and give us more healthy years of life.

The figures are alarming, dating back to 2013, and have not changed much to date. Certainly, the the

STRONG and VITAL No. 3 - 2024

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