4 ms·
There seems to be some solid data that mammograms, colonoscopies, and treating prostate cancer (with many caveats on that last one) is actually mostly not benef
by eloff 4y ago
There seems to be some solid data that mammograms, colonoscopies, and treating prostate cancer (with many caveats on that last one) is actually mostly not beneficial in reducing overall mortality.
The reasons are likely complex and nuanced, but do your research carefully if your doctor is trying to talk you into one of those. You probably will only benefit their next car payment, not your health.
For a mammogram, it doesn’t increase survival over a manual exam.
For colonoscopies, you have one in 1400 chances of saving a life and one in 1000 chances of perforating a bowel and dying here and now instead of in 30 years. There’s another exam with lower risks and most of the benefits.
For prostate cancer, if you have the aggressive kind, intervention has almost no effect. You’re dead either way.
If you have the slow growing kind, you’ll likely die of something else. The risks of treatment are mostly balanced against the benefit. But treatment will nuke your quality of life.
I don’t have time too dig up sources right now, so don’t take my word for it. Look for the studies, they’re quite approachable.
- nradov 4y agoYour estimate of colonoscopy risk versus reward is completely wrong. https://peterattiamd.com/peter-on-the-importance-of-regular-colonoscopies/ https://peterattiamd.com/peter-on-the-importance-of-regular-...
- eloff 4y agoHe doesn’t give any numbers there. I may well be completely out to lunch, but that source doesn’t modify my opinion. Here's the results of the first large randomized clinical trial - the gold standard in medicine. The study involved over 80,000 participants in Nordic countries. "colonoscopy reduced cancer incidence but not death" https://www.statnews.com/2022/10/09/in-gold-standard-trial-colonoscopy-fails-to-reduce-rate-of-cancer-deaths/ https://www.statnews.com/2022/10/09/in-gold-standard-trial-c...
- jawon 4y agoDoesn't reasoning like this fall under the ecological fallacy? You can't use statistics to predict the outcome for the individual. If I get a colonoscopy tomorrow there is not a 1/1000 chance I'll die of a perforated bowel. Except perhaps by pure coincidence. My odds will be different. Maybe 1/10. Maybe 1/10,000. A government can use statistics like these to direct spending, but as an individual you need to take your own personal history into account, and your trust in your medical professionals, and roll the dice.
- eloff 4y agoYour should assume your odds are 1 in 1000, without reason to believe otherwise. Your actual odds are obviously going to be different, but that is unknown to you and shouldn’t affect your reasoning about the risks.
- lz400 4y ago>one in 1000 chances of perforating a bowel and dying here and now that sounded impossible and googling a bit I think it's off by a couple of orders of magnitude: closer to 1 in 10000 chances of perforation, which has a single digit % of death https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811793/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811793/
- eloff 4y agoThank you, my source was probably wrong, or my memory. However, I wouldn’t be quick to say it invalidates the conclusion, without more careful analysis.