Image by Swello on Unsplash.
Recently I wrote about the Surgeon General’s advice to drink less and reduce cancer risk. I have no skin in the game: I don’t drink enough to make a difference. But like most articles, this one wrote about drinking as “the third leading preventable cause of cancer.”
There are lots of good reasons to avoid drinking. I’m just concerned about the warnings in this article.
I wanted to ask the 3 word question that would make all the difference: “By how much?”
In other words, what are we being promised?
In this case, the benefits seem quite small. As I said in the article, only 40% of cancer deaths are preventable (you can google this). So if drinking is the third leading cause, you already know that quitting will reduce your risk by less than 40%. And if you look in the one research article that was cited, you’ll see you increase risk by 5% or less.
Is that enough reason to quit? That’s up to you.
This question applies to just about any piece of medical information you get from any source.
One of Philadelphia’s leading hospitals sent out a large postcard with the message, “Mammograms save lives.” I won’t discourage anyone from getting a screening mammogram, especially if you’ve got a family history or other special factors. But the question they need to answer is, “By how much?”
Mammograms miss about 13% of breast cancers. You have to examine many women (I’ve seen numbers as high as 2000) to save one life, as the website TheNNT notes. The Breast Cancer Coalition finds minimal benefit and offers a nuanced discussion. So screening mammograms do save lives, but the picture looks different when we ask, “By how much?”
A small benefit may be enough for some people, but not for everyone.
A doctor once tried to persuade me to take a certain drug that would prevent an adverse medical condition. I asked, “By how much?” She sent me a journal article. The answer was 2.2%. That would be enough for a lot of people; it wouldn’t be for me.
I’m not urging people to ignore doctors’ advice wholesale. But I would urge people to ask those doctors how much benefit they’ll get from an actual drug or procedure or exam.
I’ve had doctors try to impress me by naming all the organizations supporting or forbidding a certain practice. They refer to the American Heart Association or the American Cancer Society or a more specific group. One retired doctor told me she followed the guidelines completely when she practiced or prescribed.
I personally don’t trust guidelines since I read this story of how they were established for bone density tests. Drug companies were heavily involved.
As with almost everything in life, it’s a case of big headlines and small benefit. You may or may not want to read between the lines and what’s a small benefit to some will be huge to others. You have to decide what’s important to you.
And remember that every test and every screening comes with a cost. Putting warning labels on alcohol will come with a cost. Is this the best use of resources? Or a gimmick that benefits a small group?
