3 ms·

How much of this is from actual increase in the disease, and how much is from earlier and more sensitive detection?

by chiefalchemist 3y ago

iknowstuff 3y ago
It compares mortality so
- bsder 3y ago
  Um, mortality ... basically didn't change? This diagram: https://bmjoncology.bmj.com/content/bmjonc/2/1/e000049/F1.large.jpg?width=800&height=600&carousel=1 https://bmjoncology.bmj.com/content/bmjonc/2/1/e000049/F1.la... Shows about 800K deaths in 1990 vs 1M deaths in 2019. That's 25% at best--or less when adjusted for population growth. And the proportions stayed roughly the same. That would strongly suggest that the increase is mostly detection.
  - lumost 3y ago
    Also points towards frustratingly limited progress in cancer treatment efficacy.
    - bsder 3y ago
      Sadly. However, I think that is about to change. Rapidly. I see biomed as broken into 3 eras much like any technical field--alchemy, science, and then engineering. The invention of PCR in 1984 is when biomed changed from being alchemy to being an actual science. The application of mRNA heralds the start of the era where biomed is switching to having progress from engineering rather than just science and some serendipitous luck. And once something switches to being engineering, it can be accelerated by education and money.
      - chiefalchemist 3y ago
        True. However, what might that mean to say the environment? For example, if cancer in humans becomes effectively 100% curable, do we become less attentive to diet, environmental toxins, etc.? I believe you're correct. But I also believe such a shift will likely come witb unintended consequences. What might those be? Note: nuclear fusion is similar. That is, loads of cheap clean energy is certainly a victory but there are also massive geopolitical and financial systems unintended consequences. It's not all rainbows and unicorns
  - potatoman22 3y ago
    The authors seem to think that cancer is less deadly now, but they also note that increased screening likely increases the prevalence of cancer: Introduction: "Currently, it was reported that the promotion of cancer screening strategies and the exposure to risk factors in early life or young adulthood may increase incidence of early-onset cancer... Furthermore, changes in diet, lifestyle and environment since the turn of the 20th century, resulting in increased rates of obesity, physical inactivity, westernised diets and environmental pollution, may have affected the incidence of early-onset cancer. Additionally, alcohol, smoking and detrimental pregnancy exposures may have also affected the incidence of early-onset cancer" Conclusion: "Our study showed that the global morbidity of early-onset cancer increased from 1990 to 2019, while mortality and DALYs slightly decreased."
    - chiefalchemist 3y ago
      Well earlier detection and improved treatment is going to lower mortality rates. But that still doesn't prove cancer has increased. Note: I personally believe it probably has but such an opinion is not science.
Solvency 3y ago
[flagged]
- streblo 3y ago
  Citation needed. The paper specifically says: > Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.
  - silentsea90 3y ago
    That is true, but by the time we figure out the right attribution between all of these, we'd be toast.
  - brohoolio 3y ago
    I’m surprised if tobacco utilization has increased during the time period in question.
    - maxerickson 3y ago
      It hasn't. It may have among younger people though, as a result of increasing incomes in poorer countries.
    - loeg 3y ago
      Not in the US, but maybe elsewhere.
  - tomtheelder 3y ago
    Low in milk??
    - notamy 3y ago
      I wonder if it's another way of saying "poor nutrition"
  - Nux 3y ago

How much of this is from actual increase in the disease, and how much is from earlier and more sensitive detection?

iknowstuff 3y ago

It compares mortality so

bsder 3y ago
Um, mortality ... basically didn't change? This diagram: https://bmjoncology.bmj.com/content/bmjonc/2/1/e000049/F1.large.jpg?width=800&height=600&carousel=1 https://bmjoncology.bmj.com/content/bmjonc/2/1/e000049/F1.la... Shows about 800K deaths in 1990 vs 1M deaths in 2019. That's 25% at best--or less when adjusted for population growth. And the proportions stayed roughly the same. That would strongly suggest that the increase is mostly detection.
- lumost 3y ago
  Also points towards frustratingly limited progress in cancer treatment efficacy.
  - bsder 3y ago
    Sadly. However, I think that is about to change. Rapidly. I see biomed as broken into 3 eras much like any technical field--alchemy, science, and then engineering. The invention of PCR in 1984 is when biomed changed from being alchemy to being an actual science. The application of mRNA heralds the start of the era where biomed is switching to having progress from engineering rather than just science and some serendipitous luck. And once something switches to being engineering, it can be accelerated by education and money.
    - chiefalchemist 3y ago
      True. However, what might that mean to say the environment? For example, if cancer in humans becomes effectively 100% curable, do we become less attentive to diet, environmental toxins, etc.? I believe you're correct. But I also believe such a shift will likely come witb unintended consequences. What might those be? Note: nuclear fusion is similar. That is, loads of cheap clean energy is certainly a victory but there are also massive geopolitical and financial systems unintended consequences. It's not all rainbows and unicorns
- potatoman22 3y ago
  The authors seem to think that cancer is less deadly now, but they also note that increased screening likely increases the prevalence of cancer: Introduction: "Currently, it was reported that the promotion of cancer screening strategies and the exposure to risk factors in early life or young adulthood may increase incidence of early-onset cancer... Furthermore, changes in diet, lifestyle and environment since the turn of the 20th century, resulting in increased rates of obesity, physical inactivity, westernised diets and environmental pollution, may have affected the incidence of early-onset cancer. Additionally, alcohol, smoking and detrimental pregnancy exposures may have also affected the incidence of early-onset cancer" Conclusion: "Our study showed that the global morbidity of early-onset cancer increased from 1990 to 2019, while mortality and DALYs slightly decreased."
  - chiefalchemist 3y ago
    Well earlier detection and improved treatment is going to lower mortality rates. But that still doesn't prove cancer has increased. Note: I personally believe it probably has but such an opinion is not science.

Solvency 3y ago

[flagged]

streblo 3y ago
Citation needed. The paper specifically says: > Dietary risk factors (diet high in red meat, low in fruits, high in sodium and low in milk, etc), alcohol consumption and tobacco use are the main risk factors underlying early-onset cancers.
- silentsea90 3y ago
  That is true, but by the time we figure out the right attribution between all of these, we'd be toast.
- brohoolio 3y ago
  I’m surprised if tobacco utilization has increased during the time period in question.
  - maxerickson 3y ago
    It hasn't. It may have among younger people though, as a result of increasing incomes in poorer countries.
  - loeg 3y ago
    Not in the US, but maybe elsewhere.
- tomtheelder 3y ago
  Low in milk??
  - notamy 3y ago
    I wonder if it's another way of saying "poor nutrition"
- Nux 3y ago