3 ms·
While I think I know what you’re getting at, there are of course examples of “detecting pathology early and then treating it” preventing morbidity, mortality, a
by dwelch 7y ago
While I think I know what you’re getting at, there are of course examples of “detecting pathology early and then treating it” preventing morbidity, mortality, and saving money. This is the basis of all (good) public health cancer screening practices. Think of a screening colonoscopy identifying a local pre-invasive adenocarcinoma and cutting it out (cure).
- Gatsky 7y agoThere are specific examples for high prevalence conditions as you cite, but the original comment was not talking about that, it was talking about a broader approach. Even taking your example, getting to the point of removing a pre-invasive adenocarcinoma is actually very complicated. You need a motivated patient, you need a healthcare team of specialist doctors or nurse practitioners, pathologists, radiologists, anaesthesiologists, nurses, an endoscopy suite, a recovery area, you need a system to follow up and track these cases etc. The full embedded cost of this undertaking is huge, I don't think it is scalable, and at the same time, will never capture everyone. Randomised studies usually just barely show that these screening approaches are better than not screening, once false positives are accounted for. Furthermore, you have chosen an example where there is a useful pre-screening test (fecal blood tests), a relatively non-invasive diagnostic test (colonoscopy) and a relatively painless intervention (removing a polyp with the scope). This is not broadly applicable. A pancreatic lesion for example is very hard to diagnose for sure, and the intervention is a massive and life changing operation.