Tuesday, July 16th 2013 at 12:30 pm
Millions
of women undergo them annually, but few are even remotely aware of just
how many dangers they are exposing themselves to in the name of
prevention, not the least of which are misdiagnosis, overdiagnosis and
the promotion of breast cancer itself.
A new study published in the
Annals of Family Medicine titled,
Long-term psychosocial consequences of false-positive screening mammography,
brings to the forefront a major underreported harm of breast screening
programs: the very real and lasting trauma associated with a
false-positive diagnosis of breast cancer.
[1]
The study found th
at women with false-positive diagnoses of breast cancer, even three years after being declared free of cancer,
"consistently reported greater negative psychosocial consequences
compared with women who had normal findings in all 12 psychosocial
outcomes."
The
psychosocial and existential parameters adversely affected were:
- Sense of dejection
- Anxiety
- Negative impact on behavior
- Negative impact on sleep
- Degree of breast self-examination
- Negative impact on sexuality
- Feeling of attractiveness
- Ability to keep 'mind off things'
- Worries about breast cancer
- Inner calm
- Social network
- Existential values
What
is even more concerning is that "[S]ix months after final diagnosis,
women with false-positive findings reported changes in existential
values and inner calmness
as great as those reported by women with a diagnosis of breast cancer."
In
other words, even after being "cleared of cancer," the measurable
adverse psychospiritual effects of the trauma of diagnosis were
equivalent to actually having breast cancer.
Given
that the cumulative probability of false-positive recall or biopsy
recommendation after 10 years of screening mammography is at least 50%,
[2] this is an issue that will affect the health of millions of women undergoing routine breast screening.
The Curse of False Diagnosis and 'Bone-Pointing'
Also,
we must be cognizant of the fact that these observed 'psychosocial' and
'existential' adverse effects don't just cause some vaguely defined
'mental anguish,' but translate into objectively quantifiable
physiological consequences of a dire nature.
For instance, last year, a groundbreaking study was published in the
New England Journal of Medicine showing that, based on data on more than 6 million Swedes aged 30 and older, the risk of suicide was found to be up to
16 times higher and the risk of heart-related death up to 26.9 times higher during the first week following a positive versus a negative cancer diagnosis.[3]
This
was the first study of its kind to confirm that the trauma of diagnosis
can result in, as the etymology of the Greek word trauma reveals, a
"physical wound." In the same way as Aborigonal cultures had a 'ritual
executioner' or 'bone pointer' known as a Kurdaitcha who by pointing a
bone at a victim with the intention of cursing him to death, resulting
in the actual self-willed death of the accursed, so too does the modern
ritual of medicine reenact ancient belief systems and power
differentials, with the modern physician, whether he likes it or not, a
'priest of the body.'; we must only look to the well-known dialectic of
the placebo and nocebo effects to see these powerful, "irrational"
processes still operative.
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