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In the general case, this is the point where medicine arrive at both a medical and ethical problem. The biopsy and further tests both involve some non-insignifi
by belorn 5y ago
In the general case, this is the point where medicine arrive at both a medical and ethical problem. The biopsy and further tests both involve some non-insignificant risk to the patient, as does overtreatment. If 99% or even higher number of patients are false positive, and the biopsy has a risk of causing significant negative sides, at what point is testing doing more harm that good?
This is the general argument against testing for prostate cancer in non-symptomatic patients. If you only test patients that has symptoms then the rate of false positives goes down. The downside is that you only catch late stage patients where treatment might be too late. The alternative (which is used for mammography) is that for every person saved, an order of magnitude more will be permanent harmed by unnecessary surgery.
- dontreact 5y agoYes it's not trivial to balance these things and this is why there have been randomized control trials that look at long term end points where both the costs of false negatives and false positives come into play. It's also why breast cancer screening is not recommended for everyone, just women over 50. For women over 50 there has been a decades long sincere effort by the medical community to take this all into account and the consensus is that screening makes sense in that population.