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Just Because You Can…

Just because you can, it doesn't mean you should look for evidence of a possible cancer. The debate over cancer screening has flared over recommendations for mammography as well as those for prostate specific antigen (PSA) blood levels. In both cases, the test is relatively easy, inexpensive, and now largely covered by insurance. On the other hand, there is a substantial body of evidence that shows the irrelevance of subjecting women to mammography before the age of 50 and asymptomatic men to a PSA test. People are largely not swayed by that finding.

Perhaps the latest suggest screening technique will get a more objective assessment by the general public. Transnasal esophagoscopy (TNE) is a procedure in which a physician must navigate a flexible periscope through your nose, past your vocal cords and down to the lower end of your esophagus, where a sample is taken. Certain physicians who practice that technique recommend screening everyone they can get their hands on ) and repeating that test annually if there is a suggestion of any cellular changes, despite the unlikelihood of those changes turning into cancer.

The debate rages, leaving one to wonder if the opportunity for profit or heroism overwhelms the evidence for reasonable actions.

An interesting small point in the article: adenocarcinoma of the esophagus, although rare, has been rising at a rate of two to three percent per year the last four years. I wonder, though, if it's persistent yet painless reflux that could be the cause, made painless by the incredible and unjustified overuse of acid-blocking medicines. See our upcoming column on Reflux Disease or GERD for more discussion.

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