The Cost of Chasing Cancer

Why excessive screening can cause unintended harm, stress and waste

By Marty Makary Monday, Mar. 10, 2014

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    The patient I met also taught me about another negative outcome, one that does not show up in the national stats: emotional trauma from false alarms. The patient recounted feeling tormented by the idea that he might be harboring a precancerous time bomb. His distress arose not from cancer but from medicine's limited ability to interpret a normal variation of anatomy discovered by new technology.

    The good news is that a grassroots movement within medicine is identifying unnecessary tests and procedures to educate doctors and the public about them. The American Board of Internal Medicine Foundation has been asking medical-specialty associations to name the five most overdone tests and procedures within their specialty. The campaign so far includes more than 60 doctors' societies.

    Reducing overdiagnosis and overtreatment will require broadening medicine's focus beyond hunting and killing disease to sound research and education on appropriate care. We all must come to grips with the public's expectation for more medicine. New research is capturing what individual stories, like that of my patient, have been trying to teach us: we have a quiet epidemic of unnecessary, costly and sometimes harmful medical care.

    Makary is a cancer surgeon at Johns Hopkins Hospital and an associate professor of health policy at the Johns Hopkins Bloomberg School of Public Health

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