Dear Kumara,
I had sme thought about this.
Some strange poeple believe that early detection by screening could
eliminate the advanced diseases. Of course it could not.
All screenings may at best reduce the number of advanced cases by the
cost of significant increase of the number of 'early cases'. E.g. In
relation to mammography screening it is shown that number of advanced
cases (and mortality) is not reduced on a large scale, but the total
number of 'cancers' is increased by at least 30% (probably 50% or more).
In the system with imited resources it means that these cancer patients
(yes, they should be managed as cancers - no option) will compete for
the access to the care.
Screening programs are expensive and necessary led to the more expenses.
With rare exception (HIV?) it is the last intervention to be introduced
in the resource scarce country.
VVV
--
\/.\/.\/.
Vasiliy V. Vlassov, MD
President, Society for Evidence Based Medicine, osdm.org
Professor, National Research University Higher School of Economics
e-mail: vlassov[a t]cochrane.ru
Web page https://www.hse.ru/en/org/persons/14527416
snail mail: P.O.Box 13 Moscow 109451 Russia
Phone Russia +7(965)2511021
On 2018-11-03 07:47, Kumara Mendis wrote:
> It has been a fantastic discussion just to be like a fly on the wall
> We so much believe that Screening is so Beneficial, especially in
> developing countries.
>
> Can you give some thoughts/views to go about explaining about screening
> to people (and even doctors) in developing countries?
> e.g. the emphasis on breast screening using mammography is a hugely
> important topic in Sri Lanka. There has been a influx of mammography
> machines to the private sector and even women from the age of 30 are
> advised to go for scanning (although many could not afford it). Will all
> the evidence that points to the harms some of the arguments are
> 1) the increase of breast ca incidence in SL (?increase screening)
> 2) services such as surgery, chemotherapy is not as advanced as in
> developed countries
>
> Would the screening results in Europe and USA be different to countries
> like Sri Lanka, India, Bangladesh where very few data is available and
> followup of scans are increasingly not reliable
> Cheers
> Kumara
>
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