Cancer screening: Understand correctly to avoid wasting money and adding more worries

People go to see a doctor and get an ultrasound at a hospital - Photo: DUYEN PHAN

Many people are afraid of cancer, listening to recommendations and actively go for cancer screening tests without knowing that they are wasting money and bringing more worries and illnesses to their bodies.

What does cancer screening actually do?

Do not harm the patient

Doctor Trinh The Cuong (Chemistry Department, Central E Hospital) said that he has warned many times about marker testing (tumor markers) - blood tests for cancer screening, but he still regularly receives images of a long list of cancer marker tests from patients "asking for help" for advice.

"Many patients bring several A4 files with a series of cancer markers to consult, the cost of the test is equal to a doctor's entire month's salary, it's heartbreaking to see" - said Dr. Cuong.

Doctors say some places take advantage of people's fear of cancer to advise and promote unnecessary tests. Most cancer marker tests are not used for cancer screening, but there are many advertisements like: 5,000 free colon cancer screening tests (CEA) for people...

"There was a case of a poor old woman who went to have her ankle examined, had a cancer marker test done for 2.5 million VND, then ran out of money to buy medicine for her leg pain. I hope doctors will think carefully when prescribing a cancer marker test for patients" - Dr. Cuong shared.

Should the CEA test (a test used to diagnose certain types of cancer) or other cancer marker tests be used indiscriminately for cancer screening?

Doctors say only those in the profession know, it doesn't really stop there.

Specifically, in the case of a patient who went for lung cancer screening using a blood test, Cyfra 21-1 was slightly increased...

This patient was shocked, worried, lost sleep and appetite, neglected work, neglected family, and lost his spirit. Then he went for a chest CT scan with diagnostic injection, which had risks of contrast and accumulated radiation, causing damage to health and money.

Especially the downside of improperly prescribed cancer screening. There was a case where a pregnant woman went back to the doctor and was prescribed a blood test for lung cancer screening (Cyfra 21-1). The results were a bit high, but being pregnant and not being able to get a CT scan of the lungs made both the family and the pregnant woman worried, affecting the fetus.

Furthermore, using tumor markers to screen for cancer in adults is not appropriate, and in many cases, cancer screening tests are also used in children.

May be harmful

Doctors and experts analyze that tumor marker index is not meaningful in cancer screening for the following 3 reasons:

Cancer screening is the detection of cancer when it has no clinical manifestations, that is, when the tumor is still small. Small tumors mostly do not increase cancer markers. Therefore, testing is just a waste of money.

Many cancers are as big as a fist and have metastasized to many places, but the cancer marker does not increase. Many patients who test for cancer markers and find them normal think they are safe, so they do not go for cancer screening according to official recommendations such as endoscopy, colonoscopy, mammogram... and when symptoms appear, the disease is already in the late stages. Thus, testing for cancer markers gives people a false sense of security.

Next, cancer markers can increase in cancer, and can increase in other diseases such as inflammation, smoking... This makes the patient's psychology unstable and improper cancer marker testing can also be harmful.

Not detected cancer early

Doctor Tran Duc Canh (K Hospital) emphasized that cancer marker testing is not necessary.

Dr. Canh analyzed that tumor markers are proteins produced and released into the blood by cancer cells or by the body's own healthy cells in response to the presence of cancer cells (or in some other benign, non-cancerous pathological conditions). These substances can be found in blood, urine, and tissue.

Tumor markers are not specific to cancer. Therefore, their presence is not sufficient to diagnose cancer. Tumor markers may be elevated in non-cancerous conditions or in cases of inflammation.

In particular, Tumor Marker does not increase even when the cancer patient is in the late stage. Therefore, blood tests for tumor markers are not recommended as a method for early cancer screening.

According to the conclusions from many studies on cancer markers, there is no blood test that can give reliable results in the survey and early detection of cancer.

For example, many people believe that a higher than normal level of CA 72-4 in the blood is definitely a sign of stomach cancer. This view is completely wrong. In fact, the CA 72-4 index can increase in some benign diseases.

CEA is a protein on the cell surface, a marker for colorectal, gastrointestinal, lung and breast cancers. CEA is also increased in smokers, people with cirrhosis, rectal polyps, ulcerative proctitis, and benign breast disease. CEA is not used for cancer screening.

Conversely, a person with stomach cancer does not necessarily have an increased CEA.

CA 19.9 is a marker of colorectal and pancreatic carcinoma. However, it can also increase in patients with hepatobiliary, gastric, hepatocellular carcinoma and many benign diseases such as pancreatitis and gastrointestinal diseases.

What tests should be done when screening for cancer?

According to medical experts, to best screen and detect cancer early, avoid unnecessary and wasteful tests and save money, you should:

- Ultrasound: should perform thyroid and neck lymph node ultrasound, abdominal ultrasound, uterine and adnexal ultrasound, breast ultrasound (for women).

- Digestive endoscopy: including esophagogastroduodenoscopy, colonoscopy - rectum.

- ENT endoscopy, cervical endoscopy, cervical cytology (for women).

- Chest CT scan to diagnose lung cancer, mediastinum...

- Basic blood tests: blood sugar, blood lipids, liver enzymes, kidney function, blood count, urinalysis.

- There is no need to do blood cancer marker tests, because they have little diagnostic value due to low sensitivity and specificity, often leading to misdiagnosis or missed diagnosis. Blood cancer markers are only indicated when there is suspicion in some cancer diseases such as AFP in the diagnosis of liver cancer or PSA in prostate cancer (in men).

With this kind of screening, it is possible to screen for over 90% of the most common cancers, with only a few other types remaining such as bone cancer, brain cancer, etc.

Source: https://tuoitre.vn/tam-soat-ung-thu-hieu-dung-de-dung-phi-tien-va-them-sau-lo-20240624225516361.htm