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When standard medical testing does more harm than good

Mammograms are among the medical tests that doctors worry are overused.

ER Productions/Corbis

Think that getting medical tests or undergoing all available screening exams is the key to health? Think again.

There is growing concern that many tests or procedures, such as computed tomography (CT scans) or mammograms are being overused simply because they are available, even though they may not help patients and, in many cases, even cause harm.

Groups of doctors in the U.S. released lists Wednesday of tests and procedures that doctors should think twice about ordering.

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The move is part of a campaign called "Choosing Wisely". Organized members of the American Board of Internal Medicine, the campaign includes lists of five services performed by nine different medical specialties.

The Wall Street Journal reports that some of the initial tests on the list include imaging scans that may not help patients, such as imaging for non-specific low back pain. There is growing concern that many patients are undergoing medical scans unnecessarily, which not only costs the system but also exposes patients to potentially harmful radiation.

The new recommendations also call for a stop to the routine prescribing of antibiotics for mild to moderate sinus infections. And it suggests avoiding chemotherapy or radiation for cancer patients with solid tumours who are in poor health, haven't responded to other treatments and don't qualify for a research trial.

While that recommendation could spark accusations that "death panels" are alive and well in the U.S., many doctors and medical organizations say it doesn't make sense, and may even be detrimental, to offer services to patients who likely won't benefit from it.

The issue of availability of screening tests and other medical procedures has become increasingly contentious in recent years as more evidence emerges that these medical services may not help patients.

Last November, for instance, there was considerable controversy when Canadian guidelines were issued saying only women aged 50 to 74 should have regular mammograms, and that they should be done every two to three years instead of annually. (The guidelines don't apply to women with high risk of breast cancer.)

Many patient groups disputed the recommendations, arguing they put the lives of women at risk. However, mounting scientific evidence shows that performing mammograms on low-risk women can increase the risk of false positives. Women can be wrongly diagnosed and undergo invasive procedures unnecessarily, for instance.

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Would you demand a medical test or procedure even if your doctor told you it would do no good?

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About the Author

Carly Weeks has been a journalist with The Globe and Mail since 2007.  She has reported on everything from federal politics to the high levels of sodium in the Canadian diet. More

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