Book Review: Seeking Sickness: Medical Screening and the Misguided Hunt for Disease

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Publication Date: 
Wed, 2013-09-11

“If you define a disease broadly enough,” he writes, “you capture a large part of the “healthy” population” 123 – or about 50 per cent of US post-menopausal women = 44 million women!” 

While millions of healthy postmenopausal women were prescribed bisphosphonates over the past two decades, this drug was recently found not only not to be effective at preventing fractures in women who had had none before, but actually leads in rare cases to weaker bones, femur fractures, esophageal cancer and osteonecrosis of the jaw, a painful and disfiguring crumbling of the jaw bone.

So what’s a person to do when your doctor says, “You should be screened for X”?

Cassels says that—before taking any screening test—we should ask a number of questions, such as: What is the test for? What effect will the test have on me? If the test says I have X, what are the treatments? How will the treatments affect me? Are they going to be worse for me than living with X? 

Those questions can be hard to muster when you’re in the doctor’s office, on the spot and feeling vulnerable. There is a simpler one you can ask, Cassels suggests. And it is: “What happens if I do nothing?”

The answer to that might do wonders for your health.

Alex Merrill is a writer who has worked with the Canadian Women's Health Network for many years.


CWHN has recently published several articles on breast cancer screening. Read them here:

Mammography screening: Weighing the pros and cons for women’s health

Unpacking the great mammography debate

Breast self-examination: What it means and why the thinking about it has changed