By SAMIR VERMANI, M.D., ABC News Medical Unit
You trust Consumer Reports when it comes to buying your next car or fridge. But now, for the first time ever, consumers can get ratings of cancer screening tests the same way they do for their toaster.
Of the 11 common screenings evaluated by the consumer watchdog group, only three were recommended — and even then, only for certain age groups. Specifically, Consumer Reports gave their most positive ratings for cervical cancer screening in women age 21 to 65 and colon cancer screening in people age 50 to 75. They gave a slightly less enthusiastic endorsement of breast cancer screening for women 50 to 74.
As for screenings for bladder, lung, skin, oral, prostate, ovarian, pancreatic and testicular cancers, none garnered the group’s recommendation.
The ratings come at a time of mammogram parties, mobile prostate screening vans, and services offered directly to consumers by screening test companies. Many medical experts, however, urge that patients make cancer screening decisions in close consultation with their physician. This way, they maintain, patients are able to ask their doctors which tests are and aren’t right for them — keeping in mind more isn’t always better.
The Consumer Reports recommendations are based on evidence-based reviews from the U.S. Preventive Services Task Force (USPSTF). USPSTF is an independent panel of prevention and evidence-based medicine experts appointed by the U.S. Department of Health and Human Services. The agency makes the evidence-based recommendations physicians look to when treating and advising patients. However, these messages have not traditionally targeted patients. That, said Dr. John Santa, is the point of the Consumer Reports rating guide.
“The USPSTF has great evidence-based data, the contents of which was not being translated to patients,” said Santa, who runs Consumer Reports’ Health Ratings Center. “We saw there was a need to get this information to consumers, so we did.”
The way they opted to convey this information was by using their traditional rating system, applying it to screening tests. In this case, the guide rated tests on whether the benefits of having the screening outweigh the harms.
ABC News Chief Health and Medical Editor Dr. Richard Besser said the straightforward and understandable rating system is useful for consumers.
“I like the way Consumer Reports uses their typical rating system — the same symbols you’d see applied to a car or a vacuum cleaner,” he said. “This is a system consumers know and are comfortable with. It is so much more user friendly than the materials that doctors usually provide.”
In addition to relying on the USPSTF guidelines, the Consumer Reports group analyzed research from leading journals and organizations, consulted with patients and medical experts, and surveyed thousands of their own readers. They found that too many people were getting unneeded tests, while too few were getting appropriate screening.
While the dangers of not being screened are obvious, the dangers of unnecessary screening are often not recognized — a product, some doctors say, of a nothing-to-lose, everything-to-gain message. Some screening tests, such as ovarian and pancreatic cancer, often don’t have the ability to detect the disease at a curable stage. Unnecessary use of other tests, meanwhile, can lead to excess treatments and biopsies that are not without their own risk for complications.
“Many doctors and patients are attached to testing,” Besser said. “There has been so much marketing around cancer screening in particular.”
Besser added that he feels the consumer-level ratings guide may add some balance to the picture.
“Only get a test when the results are more likely to improve your health than to produce harm,” Besser said. “Sometimes, it’s not as straightforward as you might think. Just because a doctor orders a lot of tests doesn’t mean that doctor is practicing smart medicine.”