4 ms·

"but even a few percent more early detections due to frequent testing would be a win" This is not the current medical thought on early screenings for various c

"but even a few percent more early detections due to frequent testing would be a win" This is not the current medical thought on early screenings for various cancers. It used to be and I was confused about it until very recently. Indeed the medical community is still wrestling with the issue of screening harms. The consensus is shifting that screening should only be done if there is an existing condition or symptom or family history. https://www.cancer.gov/news-events/cancer-currents-blog/2022/cancer-screening-guidelines-lack-harms https://www.cancer.gov/news-events/cancer-currents-blog/2022...

bluGill 3y ago
That depends on how harmful the screening is, how harmful treatment is, how harmful the disease is, how well the test works, and how common the disease is. (probably more that I'm not aware of) Most cancer treatments are really nasty. Thus false positives are really bad: you destroy someone's quality of life. The earlier cancer is discovered the better chance that we can use a less harmful treatment (if only because of smaller dose of the harmful drugs) The current breast cancer screening is an xray - which itself causes cancer (about 1 in 3000 cases of breast cancer discovered by xray wouldn't have got breast cancer in the first place without the screening - the screening is still wroth doing if you are at risk, but don't do it if you are not at risk). Breast cancer can be deadly, but if caught early it is easy to treat (normally). The medical concern generally isn't should we test all women for breast cancer, but when do we start testing and how often should we test. If this test is safer than an xray and sensitive enough it can be useful. Avoiding current breast cancer tests is good.
- mh- 3y ago
  >about 1 in 3000 cases of breast cancer discovered by xray wouldn't have got breast cancer in the first place without the screening I had no idea the risks associated with xrays for breast cancer screenings were that high. Do you have a source (for that 1:3000 assertion) I can read?
  - bluGill 3y ago
    Communication with someone who claims to be in the know. It seems reasonable, but I don't have a source and I welcome someone who cares more to go more in depth.
- tetramer 3y ago
  You're right that benefits of screening vary widely depending on type of cancer, type of test, and even a patients own co-morbidities. However, there are a lot of inaccuracies in this comment. False positives on a screening test are bad because you follow a screening test up with a confirmatory test (a biopsy for cancer) - sometimes the procedure for the biopsy results in additional complications and even death in rare cases (and if it's a false positive, a patient goes through all of that for a benign finding). I want to be very clear that oncologists are not going to start cancer treatment on the results of a screening test, you need confirmation.
- Aachen 3y ago
  > Most cancer treatments are really nasty. Thus false positives are really bad I was imagining this cheap self test like covid self tests: you don't start taking chemo, but it's an indication to see a doctor tomorrow if not today and get it checked out properly But you do raise a good point about overtreatment which I had forgotten while writing my previous comment. Whether that applies to diseases that are reliable to confirm manually and will simply kill you if you're late to the party is another matter, but I had forgotten to take it into account at all

bluGill 3y ago

That depends on how harmful the screening is, how harmful treatment is, how harmful the disease is, how well the test works, and how common the disease is. (probably more that I'm not aware of) Most cancer treatments are really nasty. Thus false positives are really bad: you destroy someone's quality of life. The earlier cancer is discovered the better chance that we can use a less harmful treatment (if only because of smaller dose of the harmful drugs) The current breast cancer screening is an xray - which itself causes cancer (about 1 in 3000 cases of breast cancer discovered by xray wouldn't have got breast cancer in the first place without the screening - the screening is still wroth doing if you are at risk, but don't do it if you are not at risk). Breast cancer can be deadly, but if caught early it is easy to treat (normally). The medical concern generally isn't should we test all women for breast cancer, but when do we start testing and how often should we test. If this test is safer than an xray and sensitive enough it can be useful. Avoiding current breast cancer tests is good.

mh- 3y ago
>about 1 in 3000 cases of breast cancer discovered by xray wouldn't have got breast cancer in the first place without the screening I had no idea the risks associated with xrays for breast cancer screenings were that high. Do you have a source (for that 1:3000 assertion) I can read?
- bluGill 3y ago
  Communication with someone who claims to be in the know. It seems reasonable, but I don't have a source and I welcome someone who cares more to go more in depth.
tetramer 3y ago
You're right that benefits of screening vary widely depending on type of cancer, type of test, and even a patients own co-morbidities. However, there are a lot of inaccuracies in this comment. False positives on a screening test are bad because you follow a screening test up with a confirmatory test (a biopsy for cancer) - sometimes the procedure for the biopsy results in additional complications and even death in rare cases (and if it's a false positive, a patient goes through all of that for a benign finding). I want to be very clear that oncologists are not going to start cancer treatment on the results of a screening test, you need confirmation.
Aachen 3y ago
> Most cancer treatments are really nasty. Thus false positives are really bad I was imagining this cheap self test like covid self tests: you don't start taking chemo, but it's an indication to see a doctor tomorrow if not today and get it checked out properly But you do raise a good point about overtreatment which I had forgotten while writing my previous comment. Whether that applies to diseases that are reliable to confirm manually and will simply kill you if you're late to the party is another matter, but I had forgotten to take it into account at all