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Fewer Than One in Ten Informed About Most Serious Downside of Mammograms

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What do nine in ten women say they were never told about mammograms, even though they thought they had the right to know?

“Fueled by economic conflicts of interest”–with the multibillion-dollar mammogram industry–“and good intentions…many women [are] being given diagnoses of breast cancer that they did not need, producing unwarranted fear and psychological stress and exposing them to treatment that can only harm them.” Treatment they don’t need. As I discuss in my video Women Deserve to Know the Truth About Mammograms, this is the problem of overdiagnosis, “the detection of pseudo disease” or abnormalities picked up at mammogram screening that look like cancer under the microscope. So, you’re diagnosed with cancer and undergo treatment, but, all along, it was just pseudo disease that never would have actually progressed to cause symptoms. The “human costs” include mastectomies and even deaths. In fact, the chance of a woman benefiting from mammograms may be “ten times smaller than the risk that she may experience serious harm in terms of overdiagnosis.”

“How many would elect to be screened [by mammogram] if they knew that for every one woman who is notionally saved by early detection, anywhere from 2 to 10 otherwise healthy women are being turned into breast cancer patients?” Well, first, are physicians even telling patients about the possibility of overdiagnosis? After all, “it is now recognized as the most serious downside” of mammogram screening. When hundreds of women were asked, fewer than one out of ten said they had been informed about it. And when they were told about the possibility of overdiagnosis, a little more than half said they wouldn’t agree to screening if it resulted in “more than 1 overtreated person per 1 life saved from death due to cancer.” “Wow. That implies that millions of Americans might not choose to be screened if they knew the whole story; however, most”–90 percent, in fact–“do not.”

Most “women are aware about false-positives results and seem to view them as an acceptable consequence of screening mammography. In contrast, most women were unaware that screening can detect cancers that may never progress” and that what they don’t know could potentially even kill them. So, when considering the pros and cons of mammograms, it would be good to consider total mortality. Can the screening help you live longer on average? In fact, mammography “has not reduced total mortality, and it is therefore misleading to claim that ‘screening saves lives.'”

Theoretically, routine mammograms should increase a nonsmoking 50-year-old woman’s “overall survival chance from 96.3% to 97.1% over 10 years.” However, “[t]hese statistics disregard deaths from overdiagnosis.” This includes deaths from the unnecessary “radiotherapy [radiation] and chemotherapy and thus increased mortality from heart disease and other malignancies [cancers] that may entirely outweigh the benefit in terms of reduced breast cancer mortality.”

You can’t irradiate the breast without exposing the rest of your chest, including your heart and lungs, to radiation. This explains why breast cancer survivors can end up with “significant and marked impairment in cardiopulmonary [heart-lung] function over the entire continuum of disease.” “Radiation therapy as a treatment for breast cancer actually increases deaths from heart disease by more than 25% and from lung cancer by nearly 80%–a big risk for a woman who may not need to take it.” We might accept that risk if we were beating back a deadly cancer, but the “main effect of screening is to produce patients with breast cancer from among healthy women who would have remained free of breast disease for the rest of their lives had they not undergone screening.” That is, some women are being turned into cancer patients for whom treatment offers zero benefit. “Compelling data” suggest that “most overdiagnosed tumours would have regressed spontaneously without treatment.”

“Still, individuals who have had a cancer detected and then removed are likely to feel that their life was saved,” but it’s perhaps ten times likelier that their lives were seriously harmed, not saved, and ten times likelier they were told they had a cancer that could kill them, but they really didn’t. Imagine being corralled into the operating room for surgery you didn’t need. Think about every doctor’s appointment and every sleepless night–all completely unnecessary–and yet you become mammograms’ greatest advocate, thinking screenings saved your life. That’s the crazy thing about mammograms and about PSA testing for prostate cancer, too. The people who are the most harmed are the ones who claim the greatest benefit.

“Overdiagnosis creates a powerful cycle…for more overdiagnosis because an ever increasing proportion of the population knows someone–a friend, a family member, an acquaintance, or a celebrity–who ‘owes their life’ to early cancer detection.” So, the worse the test is and the more overdiagnosis it causes, the more popular it becomes. Indeed, the “popularity paradox of screening” is that the more mammograms harm women, the better women seem to think they work, and the more breasts that are surgically removed completely unnecessarily, the more women swear by it.

Billions of dollars may be being wasted “for false-positive mammograms and breast cancer overdiagnosis” that could be spent on doing more for women’s health, but it’s the human costs that concern me, considering that the harms from breast cancer screening may outweigh the benefits when you include deaths caused by treatment. Based on some best- and worst-case scenario estimates, for every ten thousand women invited for ten years of mammogram screening, three to four breast cancer deaths may be avoided at the cost of around two to nine deaths from the long-term toxicity of unnecessary radiation treatments. Yet, only one in ten women undergoing mammography said they were ever told about overdiagnosis, even though nine out of ten thought they had the right to know.

Overdiagnosis is not easy to discuss. It’s a sensitive issue, but “just because communicating with patients will be difficult does not mean that we should not tackle this problem. Informed women deserve no less when deciding about breast cancer screening.” We have an ethical responsibility to let them know.

Women deserve to know the whole truth about mammograms so they can make up their own minds. I am not opposed to mammograms. I am opposed to the patronizing attitude that women should be pressured into getting them without being fully informed about the benefits and risks. Some women will still choose to get them, but others will not. It’s up to them to decide.

KEY TAKEAWAYS

Overdiagnosis–the diagnosis and treatment of breast cancer that never would have even threatened the woman’s health–has resulted in many unnecessary surgeries, radiation regimens, and chemotherapy treatments, along with unwarranted fear and psychological stress.
The chance of a woman benefiting from mammograms may be “ten times smaller than the risk that she may experience serious harm in terms of overdiagnosis.”
How much do women know about the possibility of overdiagnosis? Fewer than one in ten said they had been informed about it, and more than half said that, had they known about the possibility of overdiagnosis, they wouldn’t agree to screening if it resulted in “more than 1 overtreated person per 1 life saved from death due to cancer.”
Although most are aware of false-positive results and accept them as a consequence of mammograms, most did not know that screening can detect cancers that may never progress at all.
Unnecessary radiation resulting from overdiagnosis exposes more than just the breast. The chest, including heart and lungs, are exposed, which is why breast cancer survivors may have significantly impaired cardiopulmonary function. Indeed, radiation therapy for breast cancer treatment increases deaths from heart disease by more than 25 percent and from lung cancer by nearly 80 percent.
With overdiagnosis, it is increasingly common to know someone who “owes their life” to early detection, so screening becomes even more popular.
The harms from breast cancer screening may outweigh any benefits. For every ten thousand women invited for ten years of mammogram screening, three to four breast cancer deaths may be avoided at the cost of around two to nine deaths from the long-term toxicity of unnecessary radiation treatments.
Only one in ten women undergoing mammography said they were ever informed about overdiagnosis, even though nine out of ten thought they had the right to know.

Check out the other videos in my 14-part series on mammograms:

Nine out of Ten Women Misinformed About Mammograms
Mammogram Recommendations: Why the Conflicting Guidelines?
Flashback Friday: Should Women Get Mammograms Starting at Age 40?
Do Mammograms Save Lives?
Consequences of False-Positive Mammogram Results
Do Mammograms Hurt?
Can Mammogram Radiation Cause Breast Cancer?
Understanding the Mammogram Paradox
Overtreatment of Stage 0 Breast Cancer DCIS
Breast Cancer and the Five-Year Survival Rate Myth
Why Mammograms Don’t Appear to Save Lives
Why Patients Aren’t Informed About Mammograms
The Pros and Cons of Mammograms

For more on breast cancer, see my videos Oxidized Cholesterol 27HC May Explain Three Breast Cancer Mysteries, Eggs and Breast Cancer and Flashback Friday: Can Flax Seeds Help Prevent Breast Cancer?

I was able to cover colon cancer screening in just one video. If you missed it, see Should We All Get Colonoscopies Starting at Age 50?.

Also on the topic of medical screenings, check out Flashback Friday: Worth Getting an Annual Health Check-Up and Physical Exam?, Is It Worth Getting Annual Health Check-Ups? and Is It Worth Getting an Annual Physical Exam?.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

2019: Evidence-Based Weight Loss

2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers

2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet

2014: From Table to Able: Combating Disabling Diseases with Food

2013: More Than an Apple a Day

2012: Uprooting the Leading Causes of Death

Read More

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Learn More Than 97% of Doctors About Lead-Time Bias

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After reading this, you’ll know more than an estimated 97 percent of doctors about a critical concept called lead-time bias.

While running for president of the United States, former New York mayor Rudy Giuliani ran a campaign ad contrasting his 82 percent chance of surviving prostate cancer in the United States with the 44 percent chance of surviving it in England “under socialized medicine” where routine PSA testing for prostate cancer is not done. “To Giuliani this meant that he was lucky to be living in New York and not in York, because his chances of surviving prostate cancer seemed to be twice as high in New York. Yet despite this impressive difference in the five year survival rate, the mortality rate”–the rate at which men were dying of prostate cancer–“was about the same in the US and the UK.” How could that be? PSA testing increased survival from 44 to 82 percent, so how is that “not evidence that screening saves lives? For two reasons: The first is lead time bias…The second is overdiagnosis.”

As I illustrate at 1:05 in my video Breast Cancer and the Five Year Survival Rate Myth, overdiagnosis is when a cancer that otherwise would have never caused a problem is detected. Consider this: Let’s say that, without screening, only 400 people out of a thousand with progressive cancer are alive five years later. That means that without screening, the five-year survival rate is only 40 percent. But, let’s say that with screening, an additional two thousand cancers are overdiagnosed, meaning cancers that would have never caused a problem or may have disappeared on their own are picked up. So, because those cancers are harmless, those overdiagnosed patients all still alive five years later, assuming their unnecessary cancer treatment didn’t kill them. In this way, the five-year survival rate has just doubled, even though in either case, the same number of people died from cancer. If that’s confusing, watch the video. That’s one way the changes in survival rates with screening may not correlate with changes in actual cancer death rates.

The other way is lead time bias. Imagine a group of patients who were diagnosed with cancer because of symptoms at age 67 and all died at age 70. Each patient survived only three years. So, the five-year survival rate for the group is 0 percent. Now, imagine that the same group underwent screening. By definition, screening tests lead to earlier diagnosis. Suppose that with screening, the cancers were diagnosed in all patients at age 60 instead of 67, but, nevertheless, they all still died at age 70. In this screening scenario, each patient survived ten years, which makes the five-year survival rate for this group 100 percent. Survival just went from 0 to 100 percent! You can imagine the headlines: ” Cancer patients live three times longer with new screening test, ten years instead of three.” All that really happened in this screening scenario, though, is that the people were treated as cancer patients for an additional seven years. If anything, that would likely just diminish their quality of life.

So, that’s the second way that changes in survival rates with screening may not correlate with changes in actual cancer death rates. In fact, the correlation is zero, as you can see at 3:14 in my video. There is no correlation at all between increases in survival rates and decreases in mortality rates. That’s why “[i]f there were an Oscar for misleading statistics, using survival statistics to judge the benefit of screening would win a lifetime achievement award hands down. There is no way to disentangle lead time and overdiagnosis biases from screening survival data.” That’s why, “in the context of screening, these statistics are meaningless: there is no correlation between changes in survival and what really matters, changes in how many people die.” Yet, that’s what you see in the ads and leaflets from most of the cancer charities and what you hear from the government. Even prestigious cancer centers, like M.D. Anderson, have tried to hoodwink the public this way, as you can see at 3:57 in my video.

If you’ve never heard of lead time bias, don’t worry, you’re not alone. Your doctor may not have heard of it either. “Fifty-four of the 65 physicians [surveyed] did not know what the lead-time bias was. Of the remaining 11 physicians who indicated they did know, only 2 explained the bias correctly.” So, just by having read to this point in this blog post, you may already know more about this than 97 percent of doctors.

To be fair, though, is it possible the doctors don’t recognize the term but understand the concept? No. “The majority of primary care physicians did not know which screening statistics provide reliable evidence on whether screening works.” In fact, they “were also 3 times more likely to say they would ‘definitely recommend’ a [cancer screening] test” based on “irrelevant evidence,” compared to a test that actually decreased cancer mortality by 20 percent.

If physicians don’t even understand key cancer statistics, how are they going to effectively counsel their patients? “Statistically illiterate physicians are doomed to rely on their statistically illiterate conclusions, on local custom, and on the (mostly) inaccurate promises of pharmaceutical sales representatives and their leaflets.”

KEY TAKEAWAYS

Overdiagnosis, the detection of cancer that otherwise would never have caused a problem, can result in unnecessary cancer treatments and affect survival rates of breast cancer patients.
For example, without screening, the five-year survival rate is 40 percent. With screening, however, overdiagnosis results in more cancer patients, despite the likelihood that their cancers are harmless or may disappear on their own. And, those overdiagnosed patients should be alive after five years, which doubles the five-year survival rate, even though the same number of patients died from cancer.
Lead time bias is also an issue. Symptomatic patients may be diagnosed at a later age than had they been with screening, which, by definition, leads to earlier diagnosis. In this case, imagine patients were diagnosed without screening at age 67 and died three years later, so the five-year survival rate is 0 percent. Now imagine the group underwent screening and the cancers were diagnosed at age 60, so they were alive for ten years before dying at 70. In the screening scenario, the five-year survival rate for the group is 100 percent.
In fact, there is no correlation between increases in survival rates and decreases in mortality rates.
It is not possible to disentangle the biases of lead time and overdiagnosis from screening survival data.
The overwhelming majority of doctors–54 out of 65 physicians surveyed–are unfamiliar with lead time bias, and of the 11 who indicated they did know, only 2 explained the bias accurately.
How can doctors who don’t even understand key cancer statistics effectively counsel their patients?

There is just so much confusion when it comes to mammography, combined with the corrupting commercial interests of a billion-dollar industry. As with any important health decision, everyone should be fully informed of the risks and benefits, and make up their own mind about their own bodies. This is one installment in my 14-part series on mammograms, which includes:

Nine out of Ten Women Misinformed About Mammograms
Mammogram Recommendations: Why the Conflicting Guidelines?
Flashback Friday: Should Women Get Mammograms Starting at Age 40?
Do Mammograms Save Lives?
Consequences of False-Positive Mammogram Results
Do Mammograms Hurt?
Can Mammogram Radiation Cause Breast Cancer?
Understanding the Mammogram Paradox
Overtreatment of Stage 0 Breast Cancer DCIS
Women Deserve to Know the Truth About Mammograms
Why Mammograms Don’t Appear to Save Lives
Why Patients Aren’t Informed About Mammograms
The Pros and Cons of Mammograms

For more on breast cancer, see my videos Oxidized Cholesterol 27HC May Explain Three Breast Cancer Mysteries, Eggs and Breast Cancer and Flashback Friday: Can Flax Seeds Help Prevent Breast Cancer?

I was able to cover colon cancer screening in just one video. If you missed it, see Should We All Get Colonoscopies Starting at Age 50?.

Also on the topic of medical screenings, check out Flashback Friday: Worth Getting an Annual Health Check-Up and Physical Exam?, Is It Worth Getting Annual Health Check-Ups? and Is It Worth Getting an Annual Physical Exam?.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

2019: Evidence-Based Weight Loss

2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers

2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet

2014: From Table to Able: Combating Disabling Diseases with Food

2013: More Than an Apple a Day

2012: Uprooting the Leading Causes of Death

Read More

Continue Reading

Business

Learn More Than 97% of Doctors About Lead-Time Bias

Published

on

After reading this, you’ll know more than an estimated 97 percent of doctors about a critical concept called lead-time bias.

While running for president of the United States, former New York mayor Rudy Giuliani ran a campaign ad contrasting his 82 percent chance of surviving prostate cancer in the United States with the 44 percent chance of surviving it in England “under socialized medicine” where routine PSA testing for prostate cancer is not done. “To Giuliani this meant that he was lucky to be living in New York and not in York, because his chances of surviving prostate cancer seemed to be twice as high in New York. Yet despite this impressive difference in the five year survival rate, the mortality rate”–the rate at which men were dying of prostate cancer–“was about the same in the US and the UK.” How could that be? PSA testing increased survival from 44 to 82 percent, so how is that “not evidence that screening saves lives? For two reasons: The first is lead time bias…The second is overdiagnosis.”

As I illustrate at 1:05 in my video Breast Cancer and the Five Year Survival Rate Myth, overdiagnosis is when a cancer that otherwise would have never caused a problem is detected. Consider this: Let’s say that, without screening, only 400 people out of a thousand with progressive cancer are alive five years later. That means that without screening, the five-year survival rate is only 40 percent. But, let’s say that with screening, an additional two thousand cancers are overdiagnosed, meaning cancers that would have never caused a problem or may have disappeared on their own are picked up. So, because those cancers are harmless, those overdiagnosed patients all still alive five years later, assuming their unnecessary cancer treatment didn’t kill them. In this way, the five-year survival rate has just doubled, even though in either case, the same number of people died from cancer. If that’s confusing, watch the video. That’s one way the changes in survival rates with screening may not correlate with changes in actual cancer death rates.

The other way is lead time bias. Imagine a group of patients who were diagnosed with cancer because of symptoms at age 67 and all died at age 70. Each patient survived only three years. So, the five-year survival rate for the group is 0 percent. Now, imagine that the same group underwent screening. By definition, screening tests lead to earlier diagnosis. Suppose that with screening, the cancers were diagnosed in all patients at age 60 instead of 67, but, nevertheless, they all still died at age 70. In this screening scenario, each patient survived ten years, which makes the five-year survival rate for this group 100 percent. Survival just went from 0 to 100 percent! You can imagine the headlines: ” Cancer patients live three times longer with new screening test, ten years instead of three.” All that really happened in this screening scenario, though, is that the people were treated as cancer patients for an additional seven years. If anything, that would likely just diminish their quality of life.

So, that’s the second way that changes in survival rates with screening may not correlate with changes in actual cancer death rates. In fact, the correlation is zero, as you can see at 3:14 in my video. There is no correlation at all between increases in survival rates and decreases in mortality rates. That’s why “[i]f there were an Oscar for misleading statistics, using survival statistics to judge the benefit of screening would win a lifetime achievement award hands down. There is no way to disentangle lead time and overdiagnosis biases from screening survival data.” That’s why, “in the context of screening, these statistics are meaningless: there is no correlation between changes in survival and what really matters, changes in how many people die.” Yet, that’s what you see in the ads and leaflets from most of the cancer charities and what you hear from the government. Even prestigious cancer centers, like M.D. Anderson, have tried to hoodwink the public this way, as you can see at 3:57 in my video.

If you’ve never heard of lead time bias, don’t worry, you’re not alone. Your doctor may not have heard of it either. “Fifty-four of the 65 physicians [surveyed] did not know what the lead-time bias was. Of the remaining 11 physicians who indicated they did know, only 2 explained the bias correctly.” So, just by having read to this point in this blog post, you may already know more about this than 97 percent of doctors.

To be fair, though, is it possible the doctors don’t recognize the term but understand the concept? No. “The majority of primary care physicians did not know which screening statistics provide reliable evidence on whether screening works.” In fact, they “were also 3 times more likely to say they would ‘definitely recommend’ a [cancer screening] test” based on “irrelevant evidence,” compared to a test that actually decreased cancer mortality by 20 percent.

If physicians don’t even understand key cancer statistics, how are they going to effectively counsel their patients? “Statistically illiterate physicians are doomed to rely on their statistically illiterate conclusions, on local custom, and on the (mostly) inaccurate promises of pharmaceutical sales representatives and their leaflets.”

KEY TAKEAWAYS

Overdiagnosis, the detection of cancer that otherwise would never have caused a problem, can result in unnecessary cancer treatments and affect survival rates of breast cancer patients.
For example, without screening, the five-year survival rate is 40 percent. With screening, however, overdiagnosis results in more cancer patients, despite the likelihood that their cancers are harmless or may disappear on their own. And, those overdiagnosed patients should be alive after five years, which doubles the five-year survival rate, even though the same number of patients died from cancer.
Lead time bias is also an issue. Symptomatic patients may be diagnosed at a later age than had they been with screening, which, by definition, leads to earlier diagnosis. In this case, imagine patients were diagnosed without screening at age 67 and died three years later, so the five-year survival rate is 0 percent. Now imagine the group underwent screening and the cancers were diagnosed at age 60, so they were alive for ten years before dying at 70. In the screening scenario, the five-year survival rate for the group is 100 percent.
In fact, there is no correlation between increases in survival rates and decreases in mortality rates.
It is not possible to disentangle the biases of lead time and overdiagnosis from screening survival data.
The overwhelming majority of doctors–54 out of 65 physicians surveyed–are unfamiliar with lead time bias, and of the 11 who indicated they did know, only 2 explained the bias accurately.
How can doctors who don’t even understand key cancer statistics effectively counsel their patients?

There is just so much confusion when it comes to mammography, combined with the corrupting commercial interests of a billion-dollar industry. As with any important health decision, everyone should be fully informed of the risks and benefits, and make up their own mind about their own bodies. This is one installment in my 14-part series on mammograms, which includes:

Nine out of Ten Women Misinformed About Mammograms
Mammogram Recommendations: Why the Conflicting Guidelines?
Flashback Friday: Should Women Get Mammograms Starting at Age 40?
Do Mammograms Save Lives?
Consequences of False-Positive Mammogram Results
Do Mammograms Hurt?
Can Mammogram Radiation Cause Breast Cancer?
Understanding the Mammogram Paradox
Overtreatment of Stage 0 Breast Cancer DCIS
Women Deserve to Know the Truth About Mammograms
Why Mammograms Don’t Appear to Save Lives
Why Patients Aren’t Informed About Mammograms
The Pros and Cons of Mammograms

For more on breast cancer, see my videos Oxidized Cholesterol 27HC May Explain Three Breast Cancer Mysteries, Eggs and Breast Cancer and Flashback Friday: Can Flax Seeds Help Prevent Breast Cancer?

I was able to cover colon cancer screening in just one video. If you missed it, see Should We All Get Colonoscopies Starting at Age 50?.

Also on the topic of medical screenings, check out Flashback Friday: Worth Getting an Annual Health Check-Up and Physical Exam?, Is It Worth Getting Annual Health Check-Ups? and Is It Worth Getting an Annual Physical Exam?.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

2019: Evidence-Based Weight Loss

2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers

2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet

2014: From Table to Able: Combating Disabling Diseases with Food

2013: More Than an Apple a Day

2012: Uprooting the Leading Causes of Death

Read More

Continue Reading

Business

Does Laptop Wi-Fi Affect Fertility?

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Should laptops not be on laps? What is the effect of WiFi exposure on sperm motility and DNA damage?

“It is impossible to imagine a modern socially-active man who does not use mobile devices and/or computers with Wi-Fi function.” Might cell phones or wireless internet be harmful for male fertility? You may recall that I’ve previously discussed how the sperm of men who use Wi-Fi tend not to get along as swimmingly, but that was an observational study. You don’t really know if Wi-Fi actually damages sperm until you put it to the test, the topic of my video Does Laptop Wi-Fi Lower Sperm Counts?.

The title “Use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation” kind of gives it all away. That was “the first study to evaluate the direct impact of laptop use on human spermatozoa.” As you can see at 0:43 in my video, the data from human sperm DNA fragmentation levels in samples placed near and far away from a laptop with an active Wi-Fi connection suggest that one might not want to position a Wi-Fi device near the male reproductive organs as that “may decrease human sperm quality.”

Indeed, Wi-Fi exposure may decrease human sperm motility and increase sperm DNA fragmentation, but the effect is minor. Is a 10 percent decrease in “progressive motile” sperm really going to make a difference? Fertile men release hundreds of millions. What has yet to be done is a study looking at bouncing baby endpoints. Do men randomized to a certain WiFi exposure have a tougher time having children? It’s actually a harder study to perform than one might think. You can’t just have men avoid cell phones and laptops for a day. Yes, we make millions of new sperm a day, but they take months to mature. The sperm with which you conceive today started as a preconceived notion months before. So, you can imagine why such a study has yet to be done. You’d have to randomize men to essentially avoid wireless communications completely, or maybe come up with some kind of Faraday cage underwear.

Another reason one may not want to use a laptop computer on their lap is that the heat generated by the laptop, with Wi-Fi or not, “can warm men’s scrotums,” undermining the whole point of scrotum possession in the first place–namely, to contain the male gonads in such a way as “to allow the testes and epididymis to be exposed to a temperature a few degrees below that of core body temperature.” This all dates back to a famous series of experiments conducted in 1968.

It was an illuminating study, one might say, as the subjects’ “scrota were heated with a 150-watt electric light bulb…In some of the trials, the heat from the 150-watt bulb was increased by the use of an ordinary reflector, although the bulb alone was just as effective if placed somewhat nearer the skin. This was simpler, but was more likely to cause accidental burning by contact.” (Why can’t I seem to get Jerry Lee Lewis’ “Great Balls of Fire” out of my head?)

Now, we have nice, cool fluorescents instead of 150-watt bulbs, but heated car seats remain a “testicular heat stress factor.” Saunas aren’t a good idea for men trying to conceive. At 2:52 in my video, I show a chart of sperm counts before and after sauna exposure. Sauna exposure apparently cuts sperm production in half, and the sperm count was still down three months later. There was an apparent full recovery by six months, though. This is why you may want to go with boxers, not briefs, or even go commando. Who makes money on going au naturel, though? Enter the “scrotal cooling” industry, though a review noted that “more acceptable scrotal cooling technique” really needs to be developed. Why? Whatever are the researchers referring to?

It seems the “devices used to achieve testicular cooling” currently on the market are “not practical for day-to-day use. One device was a curved ice rubber collar filled with ice cubes,” and another was similar to a freezer gel pack “inserted in the participants’ underwear every night,” but don’t worry because it thaws in three to four hours, “resulting in a cooling effect.” Holy snowballs, Batman!

Do not, I repeat, do not put an ice pack on your scrotum. A few frozen peas and carrots in a strategically placed surgical glove can give you frostbite. (Maybe the one time vegetables can be bad for you!) Then, there’s the schvitzer, “a cotton suspensory bandage that releases fluid (water or alcohol) to keep the scrotum damp,” and, finally, a device attached with a belt that “achieve[s] scrotal cooling” with a continuous air stream.

With so many options to choose from, do laptop users really need protection from scrotal hyperthermia? You don’t know…until you put it to the test. Indeed, an increase in scrotal temperature was found in laptop computer users, scrotal temperatures up a feverish 5? Fahrenheit.

A little scrotal warmth didn’t sound that bad until I read this case report: A previously healthy 50-year-old scientist typed out a report one evening, sitting comfortably in his favorite chair with laptop on lap, but awoke the next day with “penile and scrotal blisters” that then “broke and developed into infected wounds that caused extensive suppuration,” that is, oozing pus.

Even third-degree burns have been reported, requiring surgical intervention with skin grafts. In one report, a man drank 12 units of vodka and passed out while watching a film on his laptop, which was resting on his bare thighs. The laptop burned his leg. The surgeons called for a “public education campaign” to “educate the public against the risks of using a laptop in its most literal sense.” That’s one approach, but why not educate the public instead against drinking 12 units of vodka?

KEY TAKEAWAYS

Researchers suggest positioning Wi-Fi devices away from male reproductive organizes as Wi-Fi exposure may decrease the quality of the sperm–decreasing its motility and increasing its DNA fragmentation.
Heat generated by a laptop, with or without Wi-Fi capability, is another reason not to place the device on the lap, as it can warm men’s scrotums. This undermines its functional purpose–that is, to contain the male gonads such that the testes and epididymis can be exposed to a temperature a few degrees lower than core body temperature.
Similarly, heated car seats can warm testes and sauna exposure has been found to cut sperm production in half, though there was full recovery by six months.
The “scrotal cooling” industry has emerged with devices intended to “achieve testicular cooling,” such as a rubber collars to be filled with ice cubes and freezer gel packs.
Among laptop computer users, scrotal temperatures were found to be elevated by 5?F, which seems insignificant. However, in one case report, a previously healthy middle-aged man typed out a report with his laptop on his lap and awake the next day with blisters on his penis and scrotum that broke and oozed pus.
In fact, even third-degree burns have been reported with laptop-on-the-lap use, requiring surgeries with skin grafts.

This may not just be an issue for men, as I described in my video Do Cell Phones Lower Sperm Counts? and Flashback Friday: Do Cell Phones Lower Sperm Counts? & Does Laptop WiFi Lower Sperm Counts?

For more on brain issues, check out:

Does Cell Phone Radiation Cause Cancer?
Cell Phone Brain Tumor Risk?
Do Mobile Phones Affect Brain Function?
The Effects of Cell Phones & Bluetooth on Nerve Function

I cover male fertility in videos such as:

The Role of Diet in Declining Sperm Counts
Dairy Estrogen and Male Fertility
Xenoestrogens and Sperm Counts
Soy Hormones and Male Infertility
Male Fertility and Diet
Yellow Bell Peppers for Male Infertility and Lead Poisoning?
The Effects of Obesity on Dementia, Brain Function, and Fertility

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

2019: Evidence-Based Weight Loss

2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers

2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet

2014: From Table to Able: Combating Disabling Diseases with Food

2013: More Than an Apple a Day

2012: Uprooting the Leading Causes of Death

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