In part because there are over 10,000 known human diseases and symptoms thereof may have numerous possible explanations, frequently diagnostic tests can be in-determinative or less informative than observing (termed: watchful waiting) a suspected disease’s clinical course over time. Because of diagnostic complexities population level diagnostic errors represent a significant public health problem. Nevertheless, despite the progress made in treating cancer - as Ropeik writes in his introduction two-thirds of nearly 200 types of cancer are either treatable as chronic diseases or entirely curable - cancer today remains the emperor of nosophobias that in turn leads to over-screening, over diagnosis and false positives, over treatment, potentially harmful side effects, death and excessive healthcare budgeting and wasteful spending. As one reviewer of the book wrote, “Ropeik details how the gravity force of cancerphobia warps risk perception, leading to personal and societal harms and legislative misdirection.”
During this interview Mr. Ropeik begins by clarifying the book’s discussion is at the population level, disputes the belief cancer always needs be diagnosed as soon as possible and describes the US Preventive Services Taskforce’s (USPSFT’s) work upon which his book is based. He next discusses USPSTF’s (evolving) mammography screening recommendations for breast cancer, the prevalence of associated false positive diagnoses particularly related to DCIS (ductal carcinoma in situ). He discusses his chapter regarding environmental agents as cancer agents or contributing to the fear of cancer, the lack of a relationship between federal funding and the burden of disease, e.g., breast v pancreatic cancer funding. He concludes by discussing policy solutions that can simultaneously reduce cancer phobia and improve the effectiveness and cost cancer care.
Mr. David P. Ropeik is a retired Harvard University Instructor, author, and international consultant on risk perception, risk communication, and risk management. He worked as a television reporter for WCVB-TV in Boston from 1978 – 2000 specializing on environment and science issues, wrote a science column for The Boston Globe, taught journalism at Boston University, Tufts University, and MIT, was a Knight Science Journalism Fellow at MIT and a member of the Board of Directors of the Society of Environmental Journalists. Mr. Ropeik previously published “How Risky Is It, Really? Why Our Fears Don’t Always Match the Facts,” (2010, McGraw Hill), and co-author of “RISK, A Practical Guide for Deciding What’s Really Safe and What’s Really Dangerous in the World Around You,” (2002, Houghton Mifflin). Mr. Ropeik has also authored more than 50 articles, book chapters, and other essays on risk perception and risk communication published in The New York Times, The Washington Post, The Los Angeles Times, USA Today, Scientific American, The Atlantic Monthly, Health Affairs, Issues in Science and Technology and elsewhere. He writes a blog for Psychology Today and blogged at Big Think and The Huffington Post. Among numerous awards Mr. Ropeik is a two time winner of the DuPont-Columbia Award and seven regional EMMY awards.
Information on “Curing Cancer-Phobia” is at: https://www.press.jhu.edu/books/title/12956/curing-cancerphobia.