Consumer Reports Recommends Only 3 Cancer Screening Tests

Roxanne Nelson

February 07, 2013

Only 3 of the 11 available cancer screening tests are recommended by Consumer Reports.

The stated mission of the nonprofit and independent Consumers Union, which publishes Consumer Reports, is to work for a "fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves. Over the years, the group has independently purchased, tested, and reviewed products ranging from cars to mobile phones to blood glucose meters.

Now, for the first time, they have tackled cancer screening.

The ratings are primarily based on reviews from the US Preventive Services Task Force (USPSTF), but evidence that emerged after the USPSTF report was released was also considered. The research team evaluated the number of people affected by the cancer being tested, the costs involved in testing and treatment, and the benefits of a test beyond its ability to detect cancer.

Of the 11 common screening tests that were evaluated, only 3 got a thumbs up.

In the analysis, published online and scheduled to appear in the March issue of Consumer Reports, screening tests for cervical, colon, and breast cancers received the highest ratings, indicating that they are the most effective of the currently available tests.

The majority of people should not waste their time getting screened for bladder, lung, oral, ovarian, prostate, pancreatic, skin, and testicular cancers, the report states.

"We know from our surveys that consumers approach screenings with an 'I have nothing to lose' attitude, which couldn't be further from the truth," said John Santa, MD, MPH, director of the Consumer Reports Health Ratings Center. "Unfortunately, some health organizations have promulgated this belief, inflating the benefits of cancer screenings and minimizing the harm they can do," he said in a statement.

Dr. Santa explained that the usefulness of each test was rated for specific age groups to help consumers understand when they should undergo cancer screenings and when they should skip them. "We also try to identify some high-risk factors that may make screening a reasonable choice," said Dr. Santa.

Tackling Cancer Screening

The prevailing message is that individuals have "nothing to lose and everything to gain from being screened for cancer." This is simply not true, the report notes. Although the benefits of screening clearly outweigh the risks in some cases, screening can lead to unnecessary biopsies and treatment in other cases.

"The medical and public-health community has systematically exaggerated the benefits of screening for years and downplayed the harms," H. Gilbert Welch, MD, from the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, New Hampshire, notes in the report.

Survival statistics tend to be inflated by overdiagnosis or by the detection of cancers that will never be life threatening. In addition, some advertising campaigns can be misleading, according to the report.

Tests to Take

The following 3 tests are recommended by the organization.

Screening for cervical cancer is recommended for women 21 to 65 years of age. Women 21 to 30 years should have a Pap test every 3 years, and women 30 to 65 years should have a Pap test 5 years if they have had human papillomavirus testing.

Screen for colon cancer is recommended for people 50 to 75 years. For people 76 to 85 years, screening is less valuable. For those 86 years and older, screening received a low score; for those 49 years and younger, it received the lowest possible score.

Screening for breast cancer is recommended for women 50 to 74 years. Women in their 40s and those 75 years and older should discuss screening with their healthcare provider to see whether the benefits of screening outweigh the harms, on the basis of their risk factors.

Tests to Avoid

In addition, Consumer Reports highlighted the 8 screening tests that people at low risk should avoid.

Women of all ages should forgo screening for ovarian cancer unless they deemed to be at high risk, because the tests are not very effective.

For adults in all age groups, screening for pancreatic cancer is not needed unless a person is at high risk, because there are no tests that are likely to detect the disease at a curable stage.

For men in all age groups, screening for testicular cancer is not needed unless they are at high risk. Most testicular cancers found without screening are curable.

Screening for cancers of the bladder, lung, oral cavity, and skin are only necessary in people at high risk.

Men 50 to 74 years should discuss screening for prostate cancer with their healthcare provider to see if the benefits of the test outweigh the harm, on the basis of their risk. Older men rarely need the test, and younger men should consider testing only if they are at high risk.