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The Sidney Kimmel Comprehensive Cancer Center

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Risks, Benefits and Costs

Risks and Benefits

The goal of screening for cancer is to prevent people from dying from cancer by finding cancer or pre-cancer early in those without symptoms so that treatment can be started when it is most effective.

While screening may be beneficial, sometimes screening can result in harms. A screening test might reduce the number of cancer deaths each year, but at the same time, it could increase the number of health complications in people who are screened. Health complications can arise as a result of the procedures used for screening and diagnosis and as a result of treating a cancer that was detected by screening.

A screening test might be positive even in a person who doesn’t have cancer. After a positive screening test a second diagnostic test, which can be more invasive, is usually done. False positive screening tests can lead to stress, fear and unnecessary follow-up diagnostic tests. A screening test might also “overdiagnose” a cancer, meaning that a test correctly identifies cancer in a person, but that the cancer doesn’t need to be treated at the moment because it is slow growing or not growing. Overdiagnosis can lead to unnecessary treatments and higher medical costs for patients and insurers.

Some of the other potential risks of cancer screening include:

  • The screening, diagnostic tests, and treatment could produce bad side effects. For instance, a patient might suffer bleeding or an infection after a diagnostic biopsy ordered after a positive screening test.
  • People can sometimes suffer unnecessary psychological harm as the result of a screening test. For instance, a person might worry about a screening test result that is later found to be a false positive result.
  • Sometimes a screening test result is negative even in a person who truly has cancer. This is called a false negative result. False negative results mean that there’s a delay in the diagnosis and treatment of that cancer, which could make treatment of that cancer more difficult and increase the chance of death from that cancer.

Cost

Most health insurance plans, including Medicare and Medicaid, must cover cancer screening and genetic test counseling at no cost to you if you meet the screening criteria and receive the service from a health care provider in your health insurance’s network. More information on preventive health services that are usually covered by health insurance plans at no cost to you, is available from the U.S. Centers for Medicare & Medicaid Services. Resources for Maryland residents are available through the Department of Health and Mental Hygiene, and other states may have similar programs.