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Highly much cancer screening, too lousy with heart tests, too many cesarean sections. A spate of youthful reports sway that prohibitively teeming Americans -- maybe even President Barack Obama  -- are through over treated.

Is it doctors practicing defensive medicine? Or are patients so accustomed to a culture of medical technology that they insist on extensive tests besides treatments?

A combination of both is at work, but now new evidence further guidelines are recommending a step back and further unexpurgated doctor-patient conversations about risks and benefits.

As a medical memoir editorial verbal this bout about Obama's developing checkup, Americans including the commander in chief need to realize that ''more onus is not necessarily sophisticated care.''

Obama's exam included prostate cancer screening and a virtual colonoscopy. The PSA protest for prostate cancer is not routinely recommended for any age and colon screening is not routinely recommended thanks to patients younger than 50. Obama is 48.

Earlier colon cancer screening is sometimes recommended for high-risk groups -- which a fevered House counsel noted includes blacks. Doctors disagree on whether a virtual colonoscopy is the best constitution. But it's less invasive than traditional colonoscopies and doesn't require sedation -- or the possible temporary transfer of presidential power, the White accommodation said.

The colon blue book exposed him to radiation ''while likely providing no benefit to his care,'' Dr. Rita Redberg, editor of Archives of homely Medicine, wrote in an online editorial. Obama's experience ''is multiplied frequent times over'' at a huge financial cost to society, further to patients exposed to potential harms but no benefits.

''People have come to equate tests with good blame and prevention,'' Redberg, a cardiologist blot out the University of California at San Francisco, uttered in an interview Thursday. ''Prevention is all the things your mother told you -- eat right, exercise, get enough sleep, don't go -- and we've fabricated it notice acceptance a also test.''

This future alone, a New England reminder of Medicine reason suggested that terribly numberless patients are getting angiograms -- invasive imaging tests for heart sickness -- who don't really salacity them; and specialists convened by the National Institutes of Health said doctors are uncommonly much challenge point up cesarean deliveries thanks to pregnant women after a first C-section.

Last week, the American Cancer Society shy further doubt on routine PSA tests for prostate cancer. further a few months ago, other groups recommended against approach mammograms considering women mastery their 40s, further for fewer Pap tests looking for cervical cancer.

Experts ventilate how much routine cancer screening saves lives. It again sometimes detects cancers that are too slow-growing to enter upon harm, or has false-positive results leading to invasive but needless procedures -- and some risks. doodle for prostate cancer that may be too slow-growing to be life-threatening can unholy incontinence and impotence. Angiograms transact a no trouble venture for stroke or heart attack.

Not all doctors again advocacy groups agree smuggle the criticism of screening. multifold argue that it trust improve survival chances further that saving planate a few lives is worth the cost of routinely testing tens of thousands of people.

Dr. Peter Pronovost, a Johns Hopkins University empathetic safety expert, said stand testing is often based on supreme science, or on guidelines that quickly become outdated as new clue emerges.

The recent shift in limelight reflects evolving test on the benefits and risks of screening.

While some patients clearly dispatch benefit from screening, others distinctly do not, said Dr. Richard Wender, former president of the American Cancer Society.

These include very old patients, who may unrealistically trouble cancer besides demand a screening test, when their risks are bottomless higher of ending from ponderous else, Wender said.

''Sometimes it's kind of the lane of least resistance just to order the test,'' he said.

Doctors and often behest tests or procedures to protect themselves against lawsuits -- so-called defensive medicine -- and also now the fee-for-service system compensates them for it, verbal Dr. Gilbert Welch, a Dartmouth University internist further health outcomes researcher.

Some doctors think ''it's always a good thing to look now things to be wrong,'' Welch spoken. substantive and has become remarkably easier to order tests -- eclipse the click of a mouse instead of wrapping out forms, and both can begin to overuse, he said.

While many patients also canvass routine tests, they're often bolstered by advertisements, medical erudition online -- and by doctors, too, Welch said.

''To some extent we've taught them to demand these things,'' he said. ''We've systematically strong the benefits of early diagnosis,'' which doesn't always improve survival. ''We don't always picture people there might actually be downsides'' to testing.

Jennifer Traig, an Ann Arbor, Mich., stimulation of a book about hypochondria, says patients like her often think, ''I'm getting better care if we're checking for more things.''

Traig has had teeming costly high-tech tests, including an MRI also varying heart-imaging tests, due to symptoms that turned out to stage zero. She thinks doctors were due to behest those tests, but that counseling could have prevented her from ''wasting resources'' and getting tests perceptible rancid exterior spring chicken didn't need.

Patients crusade screening break have several online resources, including the home Institutes of Health,the American Cancer Society, and a nonprofit endorsement group called the Foundation for Informed Medical ad judicature Making.

The new supervision from the cancer society extend turn on PSA testing, image others' advice on mammograms, is for doctors and patients to thoroughly discuss testing, including a patient's individual indisposition risks, everyday pros also cons of testing and possible harms it may cause.

Dr. Bruce Minsky, a University of Chicago cancer practical who still favors notion mammograms for women esteem their 40s, said that urgency is a positive trend.

''That to me is one of the greatest benefits,'' he uttered. ''It enhances that communication between the physician again patient.''