[gdpawel]

In a book written by Dr. H. Gilbert - Should I Be Tested for Cancer? - professor at the Dartmouth Medical School and co-director of the V.A. Outcomes Group in the Department of Veterans Affairs in White River Junction, Vt., admits that many doctors understand that early detection is a double-edged sword.

In fact, most learn about these problems in medical school. But once they are out of school all the forces are lined up to encourage them to test: whether it is making screening a measure of health-care quality (where the doctor who screens 100 percent is best), fear of legal liability from failure to diagnose (ever heard of a doctor sued for diagnosing cancer unnecessarily?) or financial pressure (it's quicker to order a test than to talk about why it might not be in your best interest).

For some common cancers, it is not clear that early detection and treatment actually prolong patients' lives. Early detection may just mean patients spend a longer time knowing they have cancer, and yet die at the same time they would have died anyway if the tumor had been diagnosed later. A decision to forgo cancer screening can be a reasonable option (Arch Intern Med. 2008;168(21):2300, 2302-2303, 2311-2316).