Early detection and prompt follow-up on any abnormal or uncertain test results are critical tools in the fight against common cancers. However, the number of patients – especially women – who are reluctant to schedule recommended early detection screenings remains high, while the frequency with which common cancers are missed during routine screenings also remains high. Further compounding the risks for female patients, cancers that affect primarily women, like breast and cervical cancers, are subject to a number of social and medical issues that tend to delay diagnosis and therefore treatment. While even the most well-intentioned and proficient medical professionals will not be able to detect every single illness on the first attempt, physicians and others working in health care have an obligation to pursue their patients’ best interests. If ineptitude or bias prevent them from carrying out this important work, the patients they fail may be able to seek compensation to help cover the costs of the avoidable harms they have experienced. Every situation is different, which is why it can help to speak with an experienced attorney familiar with medical law. Patients in the Albuquerque area can call Firecrest Injury Law at (505) 218-9949 to schedule personalized consultations.
Importance of Early Detection for Breast and Cervical Cancers
Early detection is known to be associated with improved outcomes after a cancer diagnosis. On the other hand, late-state diagnosis is associated with a reduced five-year survival rate in breast and cervical cancer patients. As with many other cancers, early detection and treatment are critical in ensuring the patient’s best chance of achieving remission – yet the rate of missed diagnoses remains high, with a 2020 article published by the Radiological Society of North America noting that as many as 35% of newly diagnosed cancers may have been previously missed, whether the new diagnosis is made during routine screening or the “interval” between regular check-ups.
Later diagnoses require more aggressive and invasive treatments, which in many cases are nonetheless less effective than the more moderate interventions that may succeed in removing or preventing the growth of cancer discovered in earlier stages of development. As a result, the negative impacts of late diagnosis extend even beyond the very real danger to their survival, as the increased aggressiveness of treatment often correlates with more severe side effects and reduced quality of life, both during treatment and in some cases even after a course of treatment has ultimately proven effective in achieving remission.
Risk Factors for Late Diagnosis
35% already represents an unacceptably high number of missed opportunities in the context of a disease like cancer, for which early diagnosis is strongly associated with improved patient outcomes. However, for some demographics, those numbers may be even worse. Multiple studies have found that non-white patients in the United States are more likely to experience missed diagnoses across a wide variety of health conditions – as are women, from all racial and ethnic backgrounds. Some of these numbers may be attributable in part to poor training, for clinicians, on how to recognize symptoms of disease in patients other than white men, who have traditionally been used as the “standard” subjects in medical texts and who have historically been overrepresented in “professional” fields such as medicine.
There is some evidence, however, that the treatment of patients is negatively impacting the treatment of their conditions, with Global Research and Consulting noting that doctors are less likely to pursue diagnostics for female vs. male patients and less likely to respond to female patients’ reports of pain. If your cancer-related pain has been ignored by medical professionals, an attorney with Firecrest Injury Law may be able to explain your legal options during a private consultation.
Why Early Detection Is Important
Obviously the “best-case scenario” for any type of cancer is to never get it. An ounce of prevention, so the saying goes, is worth a pound of cure. Unfortunately, the way cancer cells form – as a deviation within the body’s normal processes of cell division and regeneration – makes preventing cancer entirely a desirable, but still very distant, goal.
Limited Control Over Individual Risks
Even the admittedly important research that has gone into identifying genetic and environmental “risk factors” for various types of cancers has had limited impact in cancer prevention. While one of the most famous environmental factors known to increase individual risk levels for several types of cancer – smoking cigarettes – is relatively “easy” to avoid, many other carcinogens, including some of the endocrine disruptors researchers suspect may be linked to increased risk of certain reproductive cancers, are so ubiquitous in the environment that avoiding, or even limiting, exposure presents numerous practical difficulties for the average person.
As for the link between cancer and genetics, nobody can alter their genes, and so gene therapies for cancer – so far – have been developed with a view toward providing more targeted treatments, aiming to kill cancer cells more efficiently than older methods, while having less impact on the patient’s healthy cells. Such treatments are indeed exciting, and they represent genuinely significant advances in medical science – but, like other treatments with a longer history of use, they can usually not be initiated until cancer is already diagnosed.
Early Diagnosis Facilitates Timely Treatment
Since avoiding cancer altogether is not always an attainable goal, public health campaigns – like the Center for Disease Control and Prevention (CDC) patient guidance on breast and cervical cancer – as well as medical standards of care have prioritized early detection through the development of improved screening methods and recommended screening schedules, with the former constantly under research and the latter generally based on a combination of an individual patient’s personal and family medical history with population-level data concerning the relative risk by age group. Family medical history can be an indicator of increased genetic risk for some cancers, including breast cancer, while the risk of almost all cancers increases with an individual’s age.
The effectiveness of regular screenings as a central tool in the fight against cancer is limited by three important factors:
- Sensitivity of tests: Medical professionals use different types of tests to screen for different types of cancers. The manual self-check many women are taught to perform at home aims to identify palpable lumps or changes in the texture of breast tissue that might indicate the emergency of a tumor within the breast; the mammogram that is recommended for most women as they enter middle age is instead a type of imaging test that “looks” for changes in density or abnormal structure within the milk-producing glands or the fatty tissue that surrounds them. The primary diagnostic used to screen patients for evidence of cervical cancer, meanwhile, is the scraping and examination of cells from the cervical wall familiar to many patients as a “Pap smear” (technically the “smear” refers to the placement of scraped cells on a test slide for examination; the scraping procedure, complete with speculum, that so many women dread annually is the collection process, not the test itself). Each of these tests has its own “sensitivity” threshold – the chance that, if cancer is present when the test is performed, the disease will be detectable, as a palpable lump or an unexpected shadow or a scattering of abnormal cells on a laboratory test slide. None of these tests has a 100% detection rate, even when perfectly performed, which is one reason why the frequency of screenings recommended for some common cancers can strike many patients as inconveniently (and in some cases expensively) high: The aim is to give the available test methods regular opportunities to “find” cancer, early in its progression.
- Technical proficiency: A number of diagnostic tests used to screen for various cancers require some skill on the part of the medical professional or professionals collecting tissue samples or operating imaging devices to deliver accurate results. If the person responsible for operating the test equipment or interpreting the test results does not perform his or her job competently, then they may fail to detect signs of cancer, even if the signs are present and within the sensitivity parameters of the test as designed.
- Patient access: No screening method works when it is purely hypothetical. Many patients face numerous practical and financial obstacles in their attempts to access care, even when they are experiencing symptoms and actively trying to seek help – a situation which greatly reduces the likelihood that they will pursue the regular screenings public health officials recommend to improve chances for early detection of common cancers. Sadly, these factors can be compounded in women’s health care, especially for women who belong to racial or ethnic minorities in the United States, as noted above. The accumulation of negative experiences can lead women to hesitate before scheduling a breast exam or Pap smear, further increasing the risk that cancer may not be detected until it has already metastasized (spread).
The combination of all these factors often results in a situation in which women are reluctant to schedule screening tests for early detection of breast and cervical cancers, in part because their history with health care has left them wary of the same professional they expect to be overseeing their cancer screening procedures. Those tests themselves are not perfect, and the skill of the individual administering or reading the test can further affect the accuracy of the results.
If Your Breast or Cervical Cancer Was Overlooked, Seek Legal Advice
There is no substitute for prompt, competent medical care. However, if you are one of the many women who missed early detection for a common form of cancer, you may be eligible to gain compensation to cover the costs of medical bills that are higher than they might have been with an early diagnosis. The stage at which breast and cervical cancers are diagnosed can have enormous implications for treatment and therefore patient outcomes – but too many women, especially in minority groups, have their concerns overlooked or find themselves frustrated in attempts to access basic care. If any of this sounds familiar to you, consider scheduling a consultation with Firecrest Injury Law to discuss your legal options. Call our Albuquerque office today at (505) 218-9949 to get started.
