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Those Who Claim the Greatest Benefit From Mammograms May Ironically Suffer the Most Harm

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The mammogram paradox is that women who are harmed the most, are the ones who claim the greatest benefit.

While false-positive results, pain during the procedure, and radiation exposure may be among the most frequent harms associated with mammogram screening, overdiagnosis “is now recognized as the most serious downside of population breast screening.” Overdiagnosis is so serious that the question has been raised whether it makes breast screening “worthless.” Indeed, the value of performing routine mammograms at all is being questioned due to overdiagnosis, which is “the diagnosis and treatment of breast cancer that would never have become a threat to a woman’s health, or even apparent, during her lifetime.”

“The public thinks once you have a cancer cell in your body, it will progress predictably and inevitably to a terrible death. That is simply not true of most cancers.” Some cancers outgrow their blood supply and become starved and wither away, and others are recognized by our immune system and successfully contained. Others still “are simply not that aggressive in the first place,” so, although they might continue to grow unchecked, it may be at such a slow rate that it would be decades or even centuries before they could be big enough to cause any problems. So, in effect, you would die with your tumor instead of from your tumor.

Indeed, autopsy studies of young and middle-aged women who died in a car accident, for example, found that 20 percent of them had cancer in their breast. That’s about one in five women walking around with breast cancer. Now, that sounds a lot scarier than it is because, in that age range, the risk of dying from breast cancer is less than 1 percent. In fact, your risk of ever dying from breast cancer in your lifetime is less than 4 percent, which goes to show that many of these cancers that are found incidentally–most of them, in fact–would likely have fizzled out on their own.

The problem is that we continue to have an antiquated definition of cancer that dates back to the 1860s. To this day, cancer is defined by what it looks like under a microscope, not by what its subsequent behavior is. So, according to that mid-19th century definition, one in five women followed in that one study technically had cancer, but that doesn’t necessarily mean the cancer would go on to do anything.

So, if cancer is so common, do you even want to know about it? This is the question I discuss in my video Understanding the Mammogram Paradox. Certainly, if the cancer will progress and cause a problem, then catching it early could save your life, but if it’s never going to grow, if it’s going to remain microscopic, then finding it could actually hurt you. A likely scenario upon finding it could be: We found that you have cancer so we have to treat it with surgery, chemotherapy, and radiation–whatever it takes–and then you’d suffer all the physical effects of treatment and the psychological hell of fearing for your life. But, if in fact the cancer was never going to cause a problem, all of that would have been completely unnecessary. That is overdiagnosis.

These kinds of car accident-type autopsy studies, as you can see at 2:55 in my video, show that 7 to 39 percent of women aged 40 to 70 are walking around with tiny breast cancers and 30 to 70 percent of men older than 60 have prostate cancers. And, up to 100 percent of older adults have microscopic cancers in their thyroid glands, yet only 1 in a 1,000–0.1 percent–ends up suffering or dying from thyroid cancer. Normally, the cancer just sits there and doesn’t do anything. Likewise, even though the majority of older men may have tiny cancers in their prostates or a significant number of women have them in their breasts, the lifetime risk of death or cancer spread is only about 4 percent. So, if you had a magic wand that could pick up cancer with 100 percent accuracy and waved it in front of people, your overdiagnosis rate–the probability that the prostate cancer you’d pick up would have turned out to be harmless–is about 90 percent. This is also the case for nearly every single thyroid cancer and a significant proportion of breast cancer cases. This is why screening for these cancers–cancer of the prostate, thyroid, and breast–can be tricky or even potentially dangerous. In many cases and sometimes most cases, you would have been better off if they had never found the cancers.

This is not true for all cancers, though. Researchers have found “little evidence of overdiagnosis of either cervical or colorectal cancer,” for example. Those cancers seem to continue to grow, so the earlier you catch them, the better. When pap smears were instituted, cervical cancer death rates plummeted, for instance, and just a single sigmoidoscopy performed between the ages of 55 and 65 may decrease one’s risk of dying from colorectal cancer by up to 40 percent. In contrast, a study found that “annual mammography in women aged 40-59 does not reduce mortality from breast cancer” at all. But, if we assume a 15 percent drop and a 30 percent overdiagnosis rate, which most studies have found, that would “mean that for every 2000 women invited for [mammogram] screening throughout 10 years, 1 woman will have her life prolonged and 10 healthy women, who would not have breast cancer diagnosed if there had not been screening, will be treated unnecessarily.” That is, ten healthy women would be overdiagnosed. If they had skipped screening, they would not have been told they have breast cancer and undergone treatment they didn’t need.

“Furthermore, about 1000 women…will have had a false-positive diagnosis,” a false alarm that can be stressful while you wait for the results. But the harms caused by becoming a cancer patient unnecessarily can be lifelong–and can even mean a shorter life. “It is also important to be aware that some of the healthy overdiagnosed women will die from their treatment.” For example, radiation treatments for breast cancer can’t help but penetrate down into the heart as well, increasing the risk of heart disease, which is the number one killer of women.

This raises questions about doing routine mammography screening at all, as it “converts thousands of healthy women into cancer patients unnecessarily”–and some may not make it out alive. Ironically, though, those who do survive become mammography’s biggest cheerleaders, thinking mammograms saved their lives. The mammogram found a cancer they didn’t even know they had. Yes, the treatment was rough with the surgery, radiation, and chemo drugs, but it worked and life was saved. “What a relief she got that mammogram!” “You should get one, too!” In actuality, the more likely scenario–in fact, maybe the ten times more likely scenario–is that the treatment didn’t do anything because the cancer wouldn’t have hurt you anyway. So, you went through all that pain and suffering for nothing. That’s the crazy thing about mammograms: the people who are harmed the most are the ones who claim the greatest benefit.

KEY TAKEAWAYS

The mammogram paradox: Women who are harmed the most are the ones who claim the greatest benefit.
Overdiagnosis–the diagnosis and treatment of breast cancer that never would have even threatened the woman’s health–is recognized as the most serious downside of population breast screening, even more than false-positives, pain during the procedure, and radiation exposure.
It is a myth that a cancer cell will necessarily progress and result in death. Some cancers wither away on their own, others are successfully contained by our immune system, and many may grow so slowly that it may be decades before they could be problematic.
Cancer, when found, may be treated with surgery, chemotherapy, and radiation, causing physical and psychological trauma. If that cancer was never going to cause any health problems, none of that would have been necessary.
For example, 7 to 39 percent of women aged 40 to 70 have tiny breast cancers, 30 to 70 percent of men older than 60 have prostate cancers, and up to 100 percent of older adults have microscopic cancers in their thyroid glands, yet only 0.1 percent ends up suffering or dying from thyroid cancer.
Because of overdiagnosis, screening for cancers of the prostate, thyroid, and breast can be tricky or even potentially dangerous, but researchers have found little evidence of overdiagnosis of colorectal or cervical cancer, so early identification is best.
Routine mammograms have been said to unnecessarily convert thousands of healthy women into cancer patients. Ironically, those who survive often credit mammography for saving their lives by first identifying cancer–even though it may be ten times more likely the cancer wouldn’t have ended up causing any problems. But, because of overdiagnosis, she may have undergone surgery, radiation, and chemo anyway.

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 the eighth 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?
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
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

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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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