5 ms·

> It correctly identified when cancer was present in 51.5% of cases, across all stages of the disease, and wrongly detected cancer in only 0.5% of cases. If al

> It correctly identified when cancer was present in 51.5% of cases, across all stages of the disease, and wrongly detected cancer in only 0.5% of cases. If all 300 million Americans get blood tested each year, that is 1 and a half MILLION people who are falsely told they have CANCER. One and a half MILLION people whose life gets turned upside down, WRONGLY, due to a blood test -- at least, until they take a second one. Or a third one. Or maybe they get unlucky never learn they don't have cancer, and mess up their life treating a disease they don't have. Now, OBVIOUSLY not all 300 million Americans are going to get tested each year. But you are completely ignoring the ethical concerns surrounding telling literally .5% of those who don't have cancer that they have cancer, and the non-insignificant proportion of people who will never learn they don't have cancer (we NEED to consider even the "miniscule" probabilities at this scale), and that makes you seem like somebody who "think[s] they know better".

JumpCrisscross 5y ago
> One and a half MILLION people whose life gets turned upside down, WRONGLY, due to a blood test Culture adapts. Getting a cancer diagnosis today is a huge deal because testing is infrequent, usually in response to a problem, and the diagnosis tends to be late and accurate. If 1.5mm healthy people get a false positive every year, the general response will be stress until a second test confirms a false positive. The lack of public trust in health policy doctrine, and the support for start-ups that can operate outside those channels, comes in large part from this type of thinking.
- rackjack 5y ago
  > Getting a cancer diagnosis today is a huge deal because testing is infrequent, usually in response to a problem, and the diagnosis tends to be late and accurate. Getting a cancer diagnosis is a "huge deal" because getting cancer is one of the worst experiences a human can go through. Getting cancer carries the weight of imminent death, obviously. But some cancers can be cured with high survival rate, so what's the big deal? The deal is that these cures are often brutal chemotherapy or radiotherapy or whatever treatments that destroy your body, your sleep, your appetite, your ability to go to the bathroom yourself, your ability to do chores by yourself, your ability to do anything a normal human being can do. They DESTROY you. THAT'S the "huge deal". NOT the frequency. Cancer RUINS YOUR LIFE for the period you get treated, IF you survive the treatment at all, let ALONE the cancer. And you are proposing we tell sub-1.5 million people EACH YEAR that they might have to go through that, while STILL ignoring the proportion of the population that will never learn they have a false positive because they got unlucky (which, AGAIN, we need to consider, since even miniscule probabilities matter at this scale.) So until the day we figure out a way to make getting rid of cancer as easy as popping a pill (we're getting closer thanks to gene therapy, but patients may still receive the destructive treatments in the meantime), culture will not "adapt", it will remain a "huge deal", and we will keep "this type of thinking".
  - JumpCrisscross 5y ago
    > these cures are often brutal Heart disease is a huge deal. It ruins your life. (Maybe not in all caps.) Nevertheless, we regularly test for it, including with techniques with high rates of false positives. Few panic because almost everyone knows someone who got a false positive and didn't promptly keel over and die. If healthy adults are screened for cancer, there will be cultural memory of people who got a false positive. The response to a positive test result won't be chemo. It will be further testing, if non-invasive, or suggestions of lifestyle changes and increased monitoring of the suspected system. People aren't too stupid to understand an early test with a high false positive rate. People with family histories of cancer don't wake up every morning screaming. Some may. But barring everyone because some people will overreact is why orthodox health policy is losing public trust.
    - rackjack 5y ago
      I don't enough about heart disease treatment to comment on the degree it ruins your life. People already get further testing. People already get second opinions. In the time you are changing your lifestyle (a good option for helping treatment, I agree) and increasing monitoring you could already be progressing beyond treatability. You can argue about whether it's alright to tell sub-1.5 million people each year who don't have cancer that they have cancer (I don't think it is, but whatever). But again you can't disregard the non-insignificant number of people who get false positives. edit: Actually, not "whatever". You probably shouldn't tell sub-1.5 million people each year who don't have cancer that they have cancer.
      - burnished 5y ago
        Hey, I can see this is emotional for you, but have you considered a world in which it is not telling this vast body of people "you definitely have cancer"? Something more like "we detected XXppm of [marker] which indicates we might need to do some more testing, can we talk about [risk factors]?". It just doesn't need to be as dire as what you are projecting.
      - UnFleshedOne 5y ago
plank_time 5y ago
Do you think that technology doesn’t improve over time? You are suffering from a fixed mindset, where you think people or technology is as good as it gets now and never improve. You should read up more on growth mindsets. People and technology aren’t fixed. They change and improve over time. If people had your attitude about AIDS we would have let all AIDS patients die because “oh well nothing we can do.” Luckily those with growth mindsets and optimism didn’t listen to people like you and now AIDS patients take a single pill a day. The same could happen with cancer to, but not if people like you are in charge.
- rackjack 5y ago
  > If people had your attitude about AIDS we would have let all AIDS patients die because “oh well nothing we can do.” No, if people had my attitude about AIDS they would say "Jesus Christ, don't tell 1 and half million people each year who don't have AIDS that they might have AIDS." I am talking about diagnosis, not treatment.
- TaupeRanger 5y ago
  You are clearly confusing treatment with diagnosis/screening and should consider walking away from the conversation until you get a better understanding of the ideas being discussed here. Right now you're adding a lot of unnecessary noise with bad arguments.
  - plank_time 5y ago
    Nope. You are confidently wrong again. Early diagnosis means new ways of treating cancers like liver and pancreatic. You don’t seem to understand this. Right now there is practically no treatments for either because it’s detected so late. Maybe after 20 years of early diagnosis we can treat pancreatic cancer the same way we do others. Let me guess. You were telling people in early 2020 that N95 masks don’t work.
sdg56 5y ago
They will not be told they have cancer. They will be told they probably should check something out. Everybody already knows they might have cancer, having a negative blood test would be a huge relief.
nmz 5y ago
Maybe I'm misunderstanding this but a 0.5% false positive rate and a 51% positive rate means that you still get a 50% TRUE positive rate instead of the current rate, which is 0%. And then after you can follow up with a test that is more accurate. Everything has an error rate, even pregnancy tests do, and nobody argues that we should not use pregnancy tests.
shard 5y ago
Are you comparing that against the MILLIONS who get a correct diagnosis? I expect that the quality-adjusted life year total over all tested is higher with the test than without. Wouldn't that be worth it? I think this leans more towards the "the needs of the many outweigh the needs of the few" and less towards "tyranny of the majority".

JumpCrisscross 5y ago

> One and a half MILLION people whose life gets turned upside down, WRONGLY, due to a blood test Culture adapts. Getting a cancer diagnosis today is a huge deal because testing is infrequent, usually in response to a problem, and the diagnosis tends to be late and accurate. If 1.5mm healthy people get a false positive every year, the general response will be stress until a second test confirms a false positive. The lack of public trust in health policy doctrine, and the support for start-ups that can operate outside those channels, comes in large part from this type of thinking.

rackjack 5y ago
> Getting a cancer diagnosis today is a huge deal because testing is infrequent, usually in response to a problem, and the diagnosis tends to be late and accurate. Getting a cancer diagnosis is a "huge deal" because getting cancer is one of the worst experiences a human can go through. Getting cancer carries the weight of imminent death, obviously. But some cancers can be cured with high survival rate, so what's the big deal? The deal is that these cures are often brutal chemotherapy or radiotherapy or whatever treatments that destroy your body, your sleep, your appetite, your ability to go to the bathroom yourself, your ability to do chores by yourself, your ability to do anything a normal human being can do. They DESTROY you. THAT'S the "huge deal". NOT the frequency. Cancer RUINS YOUR LIFE for the period you get treated, IF you survive the treatment at all, let ALONE the cancer. And you are proposing we tell sub-1.5 million people EACH YEAR that they might have to go through that, while STILL ignoring the proportion of the population that will never learn they have a false positive because they got unlucky (which, AGAIN, we need to consider, since even miniscule probabilities matter at this scale.) So until the day we figure out a way to make getting rid of cancer as easy as popping a pill (we're getting closer thanks to gene therapy, but patients may still receive the destructive treatments in the meantime), culture will not "adapt", it will remain a "huge deal", and we will keep "this type of thinking".
- JumpCrisscross 5y ago
  > these cures are often brutal Heart disease is a huge deal. It ruins your life. (Maybe not in all caps.) Nevertheless, we regularly test for it, including with techniques with high rates of false positives. Few panic because almost everyone knows someone who got a false positive and didn't promptly keel over and die. If healthy adults are screened for cancer, there will be cultural memory of people who got a false positive. The response to a positive test result won't be chemo. It will be further testing, if non-invasive, or suggestions of lifestyle changes and increased monitoring of the suspected system. People aren't too stupid to understand an early test with a high false positive rate. People with family histories of cancer don't wake up every morning screaming. Some may. But barring everyone because some people will overreact is why orthodox health policy is losing public trust.
  - rackjack 5y ago
    I don't enough about heart disease treatment to comment on the degree it ruins your life. People already get further testing. People already get second opinions. In the time you are changing your lifestyle (a good option for helping treatment, I agree) and increasing monitoring you could already be progressing beyond treatability. You can argue about whether it's alright to tell sub-1.5 million people each year who don't have cancer that they have cancer (I don't think it is, but whatever). But again you can't disregard the non-insignificant number of people who get false positives. edit: Actually, not "whatever". You probably shouldn't tell sub-1.5 million people each year who don't have cancer that they have cancer.
    - burnished 5y ago
      Hey, I can see this is emotional for you, but have you considered a world in which it is not telling this vast body of people "you definitely have cancer"? Something more like "we detected XXppm of [marker] which indicates we might need to do some more testing, can we talk about [risk factors]?". It just doesn't need to be as dire as what you are projecting.
    - UnFleshedOne 5y ago

plank_time 5y ago

Do you think that technology doesn’t improve over time? You are suffering from a fixed mindset, where you think people or technology is as good as it gets now and never improve. You should read up more on growth mindsets. People and technology aren’t fixed. They change and improve over time. If people had your attitude about AIDS we would have let all AIDS patients die because “oh well nothing we can do.” Luckily those with growth mindsets and optimism didn’t listen to people like you and now AIDS patients take a single pill a day. The same could happen with cancer to, but not if people like you are in charge.

rackjack 5y ago
> If people had your attitude about AIDS we would have let all AIDS patients die because “oh well nothing we can do.” No, if people had my attitude about AIDS they would say "Jesus Christ, don't tell 1 and half million people each year who don't have AIDS that they might have AIDS." I am talking about diagnosis, not treatment.
TaupeRanger 5y ago
You are clearly confusing treatment with diagnosis/screening and should consider walking away from the conversation until you get a better understanding of the ideas being discussed here. Right now you're adding a lot of unnecessary noise with bad arguments.
- plank_time 5y ago
  Nope. You are confidently wrong again. Early diagnosis means new ways of treating cancers like liver and pancreatic. You don’t seem to understand this. Right now there is practically no treatments for either because it’s detected so late. Maybe after 20 years of early diagnosis we can treat pancreatic cancer the same way we do others. Let me guess. You were telling people in early 2020 that N95 masks don’t work.

sdg56 5y ago

They will not be told they have cancer. They will be told they probably should check something out. Everybody already knows they might have cancer, having a negative blood test would be a huge relief.

nmz 5y ago

Maybe I'm misunderstanding this but a 0.5% false positive rate and a 51% positive rate means that you still get a 50% TRUE positive rate instead of the current rate, which is 0%. And then after you can follow up with a test that is more accurate. Everything has an error rate, even pregnancy tests do, and nobody argues that we should not use pregnancy tests.

shard 5y ago

Are you comparing that against the MILLIONS who get a correct diagnosis? I expect that the quality-adjusted life year total over all tested is higher with the test than without. Wouldn't that be worth it? I think this leans more towards the "the needs of the many outweigh the needs of the few" and less towards "tyranny of the majority".