Rethinking Cancer Screening: Insights from Dr. H. Gilbert Welch

Dr. H. Gilbert Welch critically explores the complexities surrounding cancer screening in his influential book, "Should I Be Tested for Cancer? Maybe Not and Here’s Why." While early detection technologies like MRI, CT scans, and PET scans can identify cancers at an initial stage, they also carry significant drawbacks that warrant careful consideration. Welch emphasizes that such tests can produce false positives, leading to unnecessary anxiety, invasive diagnostics, and treatments for conditions that might never have caused health issues. Moreover, he discusses the phenomenon of pseudodisease—cancers that grow so slowly or not at all—that current diagnostic tools struggle to distinguish from aggressive, life-threatening cancers. This often results in overtreatment of patients whose condition might never have impacted their health. The subjective nature of cancer diagnosis further complicates matters, as pathologists may interpret tissue samples differently, creating uncertainty in determining whether cells are truly cancerous. Although screening programs like mammography can reduce relative mortality rates—by approximately 33% in breast cancer—the absolute benefit is modest, tra...