Disease Prevention From a Doctors' Perspective

Medical Author: Dennis Lee, MD
Medical Editor: Melissa Conrad Stoppler, MD

Introduction - A Doctor's philosophy concerning disease prevention

Preventing disease is different from treating diseases. In treating diseases, doctors and patients are often willing to accept a finite degree of risk of side effects in order to achieve a cure or reduction of uncomfortable symptoms. In preventing diseases, doctors are extremely risk adverse. Remember, the first priority in doctoring is to "do no harm". Thus, when prescribing an agent for prolonged periods of time to prevent a disease that may or may not occur, the doctor would not want that agent to cause adverse side effects in a healthy person.

  • Example: NSAIDs (nonsteroidal antiinflammatory drugs, a class of medications used for arthritis and other inflammatory conditions) have been known to inhibit the growth of colon polyps. Colon polyps are precursors to colon cancer. Why aren't doctors recommending NSAIDs to prevent colon cancer? Because prolonged NSAID use can have unwanted side effects such as ulcers, intestinal bleeding, and aggravation of liver and kidney diseases. Without prospective randomized placebo-controlled trials involving a large number of patients, doctors will not recommend NSAIDs for colon polyp and cancer prevention except in very special and limited situations.