4 ms·

I see it more in the vein of vaccinations. A preventive care activity, not as a reaction to a symptom. Speaking only for myself, I am regularly screened, asympt

I see it more in the vein of vaccinations. A preventive care activity, not as a reaction to a symptom. Speaking only for myself, I am regularly screened, asymptomatically, for skin, prostate and colon cancers. That screening is a non-event for me because I grew up knowing that we will get screened on a regular basis for these cancers. With additional asymptomatic testing, there will be false positives. Re-test using a specific test and if still positive, a biopsy. How frequently do false positives lead to unnecessary procedures with the current asymptomatic screening? What would the rate of unnecessary intervention be, vs the rate of lives saved through early detection?

jacquesm 5y ago
With the present invasive methods of excising cancer the answer is that on an individual basis you might be better off with early detection but on a statistical basis across a larger population you'll be worse off. The important variables are patient age, how aggressive the cancer is (growth rate), what the risks of that particular type of cancer metastasizing are, what your genetic disposition is etc.
- 11thEarlOfMar 5y ago
  Again, personally, I lost both parents to cancer. One thyroid (very slow progression) one pancreatic (very fast). In both cases, I believe that pre-symptomatic detection would have had a high probability of eradicating their cancers. That experience skews my view and if I get the opportunity, I'll have these tests done 3x annually. But I understand your point. How about making it elective? That way, people who prefer to not endure the risk of false positives or the anxiety of awaiting the test results can opt out.
  - jacquesm 5y ago
    I'm really sorry for your loss, but please try to keep a healthy balance between personal tragedy versus medical policy set for a whole population, which are two entirely different things. For any particular individual, especially those who end up dying from cancer early detection would have likely mattered. Which is exactly where the problem lies: that is a large number of people, but still (much) smaller than the number of people who will end up with positive cancer test. And policy is set by the outcome for the population as a whole, not for any particular individual. In most places in the developed world cancer screening is already elective, but not for all types of cancer. Even so, how often are you going to do it? Once every year could easily be too slow to make a difference, and these tests aren't free so say a bi-annual test on all of the population would wreck the ability of the medical world to do much else. This is a tough problem to solve, especially because wetware tends to be finicky to work on and tiny little details will have a huge effect on outcome.
    - BallyBrain 5y ago
      Does anyone know which tests are availabe today excluding CT scans. For men (which is relevant to me) I know of: Prostate, Skin, Colon

jacquesm 5y ago

With the present invasive methods of excising cancer the answer is that on an individual basis you might be better off with early detection but on a statistical basis across a larger population you'll be worse off. The important variables are patient age, how aggressive the cancer is (growth rate), what the risks of that particular type of cancer metastasizing are, what your genetic disposition is etc.

11thEarlOfMar 5y ago
Again, personally, I lost both parents to cancer. One thyroid (very slow progression) one pancreatic (very fast). In both cases, I believe that pre-symptomatic detection would have had a high probability of eradicating their cancers. That experience skews my view and if I get the opportunity, I'll have these tests done 3x annually. But I understand your point. How about making it elective? That way, people who prefer to not endure the risk of false positives or the anxiety of awaiting the test results can opt out.
- jacquesm 5y ago
  I'm really sorry for your loss, but please try to keep a healthy balance between personal tragedy versus medical policy set for a whole population, which are two entirely different things. For any particular individual, especially those who end up dying from cancer early detection would have likely mattered. Which is exactly where the problem lies: that is a large number of people, but still (much) smaller than the number of people who will end up with positive cancer test. And policy is set by the outcome for the population as a whole, not for any particular individual. In most places in the developed world cancer screening is already elective, but not for all types of cancer. Even so, how often are you going to do it? Once every year could easily be too slow to make a difference, and these tests aren't free so say a bi-annual test on all of the population would wreck the ability of the medical world to do much else. This is a tough problem to solve, especially because wetware tends to be finicky to work on and tiny little details will have a huge effect on outcome.
  - BallyBrain 5y ago
    Does anyone know which tests are availabe today excluding CT scans. For men (which is relevant to me) I know of: Prostate, Skin, Colon