Download Behind the Screen

Non-fiction: Behind the Screen
Behind the Screen
By Kirsten Weir
Is testing healthy people for cancer unnecessary and wasteful?
Nowadays, almost every kind of cancer seems to have its own public
awareness campaign urging people to get tested— even if they have no sign
of disease. Catching cancer early saves lives, the campaigns tell us. So
here’s a surprise: Those warnings might not be true. The benefits of early
cancer screening are being oversold, say critics.
“Unfortunately, most of the screening tests for cancer that are being
promoted to the public don’t have good evidence [that they save lives],”
says Barry Kramer, the associate director for disease prevention at the
National Institutes of Health.
False Positive
Starting in their teen years, most women are screened regularly for cancer
of the cervix, the lower part of the uterus. That makes good sense. “There’s
very strong evidence that cervical cancer screening decreases the risk of
dying of cervical cancer,” says Kramer.
Evidence also shows that screening healthy people for breast cancer and
colorectal cancer decreases the odds of dying of those diseases. (Colorectal
cancer is cancer of the colon and rectum.) But those are the exceptions. For
the vast majority of cancers, says Kramer, there’s no evidence that
screening healthy people does any good at all.
In fact, the tests may do damage. For one thing, the tests aren’t perfect.
They often give false positives—results suggesting that diseases might be
present when, in fact, they’re not. Kramer recently followed healthy men
and women who were screened repeatedly for four common cancers—
colorectal cancer and lung cancer, plus breast cancer in the women and
prostate cancer in the men. The prostate is a gland in the male reproductive
system.
The results were startling. In three years of regular screening, the women
had a 50 percent chance and the men a 60 percent chance of receiving a
false positive.
1
®
© 2012 ReadWorks , Inc. All rights reserved.
Article: Copyright © 2010 Weekly Reader Corporation. All rights reserved.
Weekly Reader is a registered trademark of Weekly Reader Corporation.
Used by permission.
Non-fiction: Behind the Screen
Being told you might have cancer is obviously terrifying, inducing a lot of
anxiety. That’s not the only concern, however. People with suspicious test
results often undergo additional tests that carry their own risks. Some of the
patients Kramer followed underwent unnecessary—and risky—procedures,
such as surgeries and biopsies. A biopsy is a medical procedure that
removes tissue for examination.
Other follow-up tests often employ X-rays, a form of high-intensity radiation
that is used to create images of the inside of the body. Exposure to
radiation, including X-rays, can increase a person’s risk of getting cancer in
the future, especially if many X-rays are received over a lifetime. The
majority of people won’t get cancer from X-rays, Kramer stresses. Still,
exposing healthy individuals to unnecessary radiation is a needless risk. “We
should be careful before we start routinely applying X-rays to young people,”
he says.
Disease Of Aging
Even in cases where screenings find evidence of cancer, the risks of the tests
may not outweigh the benefits, Kramer says. How can that be?
With few exceptions, cancer is a disease of aging. Older people are much
more likely than young people to develop cancer. And many cancers grow
extremely slowly, if they grow and spread at all. Some even disappear on
their own. “Most common cancer screenings will detect cancer that wouldn’t
have caused a medical problem or death,” Kramer says. In other words,
many people with cancer will die from other causes long before the cancer
ever makes them sick.
A good example is prostate cancer. More than half of men age 60 or older
have cancer cells in their prostates, he says. For most men, though, the
cancer will never be a problem.
But when people discover that they have cancer, they naturally want to treat
it. And cancer therapy itself can be risky. Older, less healthy people, in
particular, might not survive the surgeries or the aggressive drug treatments
used to treat cancer.
Critics also argue that the thousands of unneeded cancer tests performed
each year drive up medical costs, making health care more expensive for the
people who are truly sick.
2
®
© 2012 ReadWorks , Inc. All rights reserved.
Article: Copyright © 2010 Weekly Reader Corporation. All rights reserved.
Weekly Reader is a registered trademark of Weekly Reader Corporation.
Used by permission.
Non-fiction: Behind the Screen
Be Informed
Anyone with signs or symptoms of cancer should get checked right away, of
course. But for healthy people, Kramer and others argue, the benefits of
cancer screening usually don’t outweigh the risks.
Not everyone agrees with that claim. The American Urological Association
recommends that men get screened for prostate cancer beginning at age 40.
Peter Carroll, a physician and professor at the University of California, San
Francisco, helped write that recommendation.
iStockphoto
Carroll argues that the risks usually don’t come from the screening tests
themselves, but from treating diseases that don’t need to be treated. “The
debate has to be much more focused on the issue of overtreatment,” he
says. Instead of treating everyone diagnosed with cancer, he argues,
doctors should do a better job of identifying patients with small, slowgrowing cancers that don’t need treatment.
Kramer and Carroll do agree that patients should be told about all the
downsides before deciding whether to get screened. “When people say ‘I’m
entitled to information,’ I think they want information that’s accurate and
reliable,” Kramer says.
“Get tested,” the ads tell us. “Get screened.” But before you do, consider the
evidence.
3
®
© 2012 ReadWorks , Inc. All rights reserved.
Article: Copyright © 2010 Weekly Reader Corporation. All rights reserved.
Weekly Reader is a registered trademark of Weekly Reader Corporation.
Used by permission.
Non-fiction: Behind the Screen
Explaining the Drops
Screening tests look for early signs of cancer before a person develops
symptoms. Studies show that screening has played a role in the declining
rates of cervical cancer and colorectal cancer. But no proof exists that
screening has played a role in reducing deaths from lung, ovarian, prostate,
and skin cancers, according to the U.S. Centers for Disease Control and
Prevention. The decline in lung cancer rates has occurred solely because
fewer Americans are smoking.
MCT/Newscom
Source: National Cancer Institute, American Cancer
Society.
4
®
© 2012 ReadWorks , Inc. All rights reserved.
Article: Copyright © 2010 Weekly Reader Corporation. All rights reserved.
Weekly Reader is a registered trademark of Weekly Reader Corporation.
Used by permission.
Questions: Behind the Screen
_____________ Date: _______________________
Name:
1. Paragraph 10 states that “cancer is a disease of aging.” Which statement supports
that claim?
A
B
C
D
Women should be screened for cervical cancer when they are teenagers.
Younger people are more likely than older people to develop cancer.
Some cancers grow and spread extremely quickly.
More than half of men age 60 or older have cancer cells in their prostates.
2. The author argues that before getting screened for cancer, a healthy person should
consider the evidence. What evidence does the author present that might lead a healthy
person to get screened?
A A positive screening could create a lot of unnecessary anxiety for the person.
B Follow up tests can expose the person to radiation, which could cause cancer.
C There is no proof that screening has helped reduce deaths from lung, ovarian,
prostate and skin cancers.
D The odds of dying from cervical, breast and colorectal cancer are decreased by
screening healthy people.
3. Review the graphs of U.S. cancer rates. What conclusion could be made from the
graphs?
A Since the incident and mortality rates are decreasing, people are getting better
at preventing and treating some cancers.
B Since lung cancer incident and mortality rates increase then decrease, more
people must be getting screened for that cancer since 1990.
C Since the cervical cancer incident and mortality rates are currently low, women
do not need to be screened for that cancer anymore.
D Since the incident and mortality rates are increasing, people are getting worse
at preventing and treating cancer.
4. Read the following sentence: “ Unfortunately, most of the screening tests for cancer
that are being promoted to the public don’t have good evidence [that they save lives].”
The word screening means
A
B
C
D
showing of a movie
guarding from germs
testing for a disease
treating an illness
1
© 2012 ReadWorks®, Inc. All rights reserved.
Questions: Behind the Screen
5. The main idea of this passage is that
A screening healthy people for some types of cancer can be unnecessary
B someone with symptoms of cancer should put off getting screened because of
false positives
C the benefits of early screening outweigh the costs for all types of cancer
D the likelihood of getting a false positive for cancer screenings is very low
6. According to the passage, for which types of cancer does it help to screen healthy
people?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
7. According to Barry Kramer’s research, how likely were men and women to receive a
false positive from their cancer screenings? What conclusion can you make about
Kramer’s findings?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
8. The question below is an incomplete sentence. Choose the word that best completes
the sentence.
Unneeded cancer tests drive up medical costs _____________ health care becomes
more expensive for everyone, including people that are truly sick
A
B
C
D
before
therefore
yet
because
2
© 2012 ReadWorks®, Inc. All rights reserved.
Questions: Behind the Screen
9. Answer the following questions based on the sentence below.
Healthy people that screened positive for cancer undergo procedures such as surgeries,
biopsies or x-rays to confirm whether the screening was accurate or a false positive.
Who? healthy people that screened positive for cancer
(do) What? _____________________________________________________________
Why? _________________________________________________________________
Directions: Read the vocabulary word and definition below to complete questions 10a,
10b, and 11.
Vocabulary Word: entitled (en · ti · tled): to have the right to do or get something.
10a. Read the sentences below and underline all forms of the word entitled.
1. The young boy felt he was entitled to eat candy after every meal, but his
mother had not given him permission and he got an apple instead.
2. Because the First Amendment is part of the Constitution, Americans are entitled
to the freedom to practice any religion.
3. Because the family had a membership to the zoo, they were entitled to go to
special animal events.
4. The listener won the radio contest, which meant that she was entitled to free
concert tickets.
5. The tabloid photographer felt entitled to take pictures of celebrities because
readers want to know about celebrities’ personal lives.
3
© 2012 ReadWorks®, Inc. All rights reserved.
Questions: Behind the Screen
10b. In front of which person are you entitled to defend yourself if you are accused of a
crime?
11. Do you think you are entitled to the same rights in other countries as you are in the
United States?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
4
© 2012 ReadWorks®, Inc. All rights reserved.