H. Gilbert Welch

H. Gilbert Welch is an American academic physician and cancer researcher. He is an internist at the Veterans Administration Medical Center in White River Junction, Vermont, as well as a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice.[1]

Education

Welch received his BA from Harvard University in 1976, his MD from the University of Cincinnati in 1982, and his MPH from the University of Washington in 1990.[1]

Career

Welch joined Dartmouth Medical School as an assistant professor in 1990.[2] He was promoted to associate professor there in 1995, and to full professor in 2000.[2]

Research

Welch is known for his research into cancer screening. In 2012, Welch co-authored a study which found that mammography was having little to no impact on breast cancer death rates. The study also concluded that substantial overdiagnosis was associated with mammographic screening, "accounting for nearly a third of all newly diagnosed breast cancers."[3][4] In 2014, Welch and two other researchers published a perspective piece in the New England Journal of Medicine examining trends in thyroid cancer incidence and mortality in South Korea. The paper found that thyroid-cancer mortality has not changed appreciably from 1993 to 2011 despite the rate of diagnoses for this type of cancer increasing by a factor of 15 during the same time period.[5][6] In 2016, he led a study which concluded that women were more likely to be diagnosed with a small tumor that will never increase in size through mammography than she is to have a dangerous tumor detected through the practice.[7][8]

Views on early detection

Welch is critical of the concept of early detection in medicine,[9][10] stating that "we have exaggerated the benefits of medical care, and we've underplayed — or ignored entirely — the harms. This is particularly true when it comes to early detection."[11] He has also argued that mammograms tend to detect abnormalities that are "not destined to cause them [women who undergo screening] any problems" but are still labeled cancer in these women.[12]

References

  1. 1 2 "H. Gilbert Welch, M.D., M.P.H.". Geisel School of Medicine. Retrieved 16 July 2015.
  2. 1 2 "H. Gilbert Welch, M.D., M.P.H. Curriculum Vitae" (PDF). Retrieved 16 July 2015.
  3. ↑ Bleyer, Archie; Welch, H. Gilbert (22 November 2012). "Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence". New England Journal of Medicine. 367 (21): 1998–2005. doi:10.1056/NEJMoa1206809. PMID 23171096.
  4. ↑ Knox, Richard (21 November 2012). "With Routine Mammograms, Some Breast Cancers May Be Overtreated". NPR. Retrieved 16 July 2015.
  5. ↑ Ahn, Hyeong Sik; Kim, Hyun Jung; Welch, H. Gilbert (6 November 2014). "Korea's Thyroid-Cancer "Epidemic" — Screening and Overdiagnosis". New England Journal of Medicine. 371 (19): 1765–1767. doi:10.1056/NEJMp1409841. PMID 25372084.
  6. ↑ Aschwanden, Christie (24 November 2014). "The Case Against Early Cancer Detection". FiveThirtyEight. Retrieved 16 July 2015.
  7. ↑ Welch, H. Gilbert; Prorok, Philip C.; O’Malley, A. James; Kramer, Barnett S. (13 October 2016). "Breast-Cancer Tumor Size, Overdiagnosis, and Mammography Screening Effectiveness". New England Journal of Medicine. 375 (15): 1438–1447. doi:10.1056/NEJMoa1600249.
  8. ↑ Associated Press (12 October 2016). "New study questions value of mammograms for breast cancer screening". CBS News. Retrieved 15 October 2016.
  9. ↑ Perry, Susan (6 November 2014). "Thyroid cancer in South Korea: a cautionary tale about the dangers of overdiagnosis". MinnPost. Retrieved 16 July 2015.
  10. ↑ Chedekel, Lisa (26 October 2011). "Overdiagnosis: Bad for You, Good for Business". BU Today. Retrieved 16 July 2015.
  11. ↑ Belluz, Julia (16 April 2015). "Celebrities keep pushing for more cancer screening. This Dartmouth professor makes the case for less.". Vox. Retrieved 16 July 2015.
  12. ↑ Kaplan, Karen (19 February 2014). "Cancer screening expert to radiologists: Stop lying about mammograms". Los Angeles Times. Retrieved 16 July 2015.
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