Barry Kramer (from The National Cancer Institute) on lead-time bias (using an image of Snidely Whiplash tying someone to train tracks): ‘Ineffective screening is like a pair of binoculars for the person tied to the tracks: you can see the train coming at you sooner, but it doesn’t change the moment of impact. Survival rates after a screening diagnosis increase, even when no one lived a day longer: people have cancer for longer when the diagnosis comes long before any symptoms. Screening is effective, on the other hand, when earlier detection means more people do well than would have done if they’d gone to the doctor first when there were symptoms.’ Yet people who do not understand lead time bias (yes, even doctors!) mis-read research findings and spread misinformation that screening mammography is effective ie that women whose breast cancer is found by screening mammography live longer than those with symptomatic breast cancer.
Nothing Personal: Disturbing Undercurrents in Cancer Care
Used in medical education.
Includes referenced discussion sections for evidence-based practice.
- Medical Journalists' Association Open Book Award
"A landmark for the patient voice"
- Macmillan Cancer Support
"A remarkable book... essential reading for all who deal with cancer patients - health professionals, politicians, health service developers, carers and, of course, patients themselves... will surely inspire change."
- Professor Karol Sikora in his foreword.