6 ms·

So for a test like this, do you just give it to everyone without symptoms? For a very high mortality cancer is it even useful to test after you have reason to

• allturtles 2y ago
  AFAIU, with pancreatic cancer usually by the time you have symptoms you are already stage 4 and uncurable. So I'm assuming the intent is to test non-symptomatic people.
  • duxup 2y ago
    That's what I was assuming as well. But then that leads to my other question, do we really regularly screen people this proactively for much at all?
    • The_Colonel 2y ago
      Measuring your blood pressure is an example of proactive screening. I assume we will start screening for things like cancer when the test will be as simple / cheap as measuring your blood pressure.
    • mwigdahl 2y ago
      In the US, asymptomatic people 50+ are routinely screened for colon cancer with a much more expensive and invasive process. A cheap blood test for another major killer seems pretty reasonable to add in.
      • alistairSH 2y ago
        Are we still doing colonoscopies on "everybody", or are we pivoting to the mail-in stool sample tests? FWIW, my health plan sent my wife and I the mail-in kits last year.
        • bluGill 2y ago
          There is still debate on that. Colonoscopies are expensive and invasive, but they are the "gold standard". A colonoscopy is every 10 years, the mail in sample is every 3 (check with your doctor to see what is right for you). The mail in sample is not as sensitive as well - I used to know someone who died of colon cancer 1 year after a negative mail in sample, a colonoscopy would have saved her life. If the mail in sample finds anything they send you to a colonoscopy anyway (but you get to the front of the waiting list) to fix the problem. For people at low risk the mail in sample is likely good enough, and since a colonoscopy has other risks (including kill you) may even be on balance be better for those. However anyone with a higher risk should get colonoscopies. Where the line between low and high risk is though is very much up for debate. The above is general discussion. For medical advice talk to your doctor - who will know the right questions to ask to figure out what is right for you.
          • unsupp0rted 2y ago
            How do the "mail-in" samples compare against the Amazon "take a dab of stool and mix it in this bottle and look for a color change" test kits?
            • bluGill 2y ago
              Depends. there are several different tests. Many are testing a for more things. I'm pretty sure the person I knew above who died a year latter had a basic test and we don't know if the better ones would have caught hers in time.
              • unsupp0rted 2y ago
                How long prior to that mail-in test was her previous colonoscopy?
    • absolutelastone 2y ago
      There's a long list of stuff people are supposed to be screened for. Many people die of stuff that has high survival rates when caught early. Pap tests, mammograms, prostate exams, are other examples for cancer.
      • moooo99 2y ago
        Don’t forget about skin cancers. Screening for it is easily among the least invasive and least uncomfortable screening procedures for any kind of cancer, yet many people miss the opportunity for an early diagnosis
• ethbr1 2y ago
  The intent of non-invasive tests like this are that you give them to everyone, at scale, frequently. And specifically tune them to minimize false negatives. Worst case with a false positive? You're causing someone anxiety and giving them an extra scan. Best case? You just saved someone's life by detecting an aggressive cancer early enough to do something about it. At the end of the day aggressive, metastatic cancer is a time game. If the cancer is given time, it becomes progressively harder and harder to treat, and effective treatment options become tougher on the rest of the body, until finally there's nothing to be done. So anything that gains time is critical.
  • giantg2 2y ago
    They generally aren't going to give them to everyone. They will give them to everyone within a certain group, such as age 30+ since the under 30 group is very low risk (unless family history, etc). Similar to how they don't test most kids and younger people for cholesterol - it's just not a significant problem for that age group.
    • ethbr1 2y ago
      Traditionally, tests have been metered that way because of costs (expensive reagents, preparation, processing) or side effects (radiation from scans). But the actual relevant equation is {cost of testing} vs {cost of delayed treatment} If the cost of testing, in economic and health senses, decreases while the cost of delayed treatment holds constant, a different mass deployment optimal point is created. Thankfully broader proactive testing is also in insurance companies' financial interests, given the high costs of late stage cancer treatment.
    • bluGill 2y ago
      Nearly everyone will reach 30 in their life, so it is safe to say we give them to everyone. It isn't a one and done test, cancer can form at any time in your life. To be useful we need to give this to everyone over 30 (40, 50....?) , on a regular schedule (yearly?). The article doesn't specify those details (or at least not before I hit the sign in wall)
    • 2y ago
• jillesvangurp 2y ago
  Depends, colon cancer, breast cancer, prostrate cancer, etc. are pretty commonly tested/screened for in certain age groups and that definitely saves lives. My aunt died of pancreatic cancer last year. It's a pretty common and aggressive form of cancer. She only had a few months from diagnosis to the grave. By the time she got diagnosed, there was nothing that they could do except provide pain relief.
  • bluGill 2y ago
    My dad got lucky to get his detected relatively early (they happened to be doing an unrelated test and "saw something", but that just meant two years of chemo and all those side effects before he died. If they hadn't found it when they did it would have been 1 year of side effect free life followed by 6 months of pain for something untreatable - in short overall a better end of life though he would have lost 6 months. If they had found it 6 months sooner though odds are it would have been treated and he would still be with us.
    • blindriver 2y ago
      If we don't detect more people early and try to cure them, it will never be solved. The more people that get detected early, the better chance everyone has of surviving, especially those in the future.
• chasebank 2y ago
  Isn't this fundamentally a statistical issue? With a test sensitivity of 99%, meaning a 1% false positive rate, administering it universally to individuals would generate a significant number of false positives. This influx could overwhelm the system, potentially limiting access for those who genuinely require medical attention.
  • duxup 2y ago
    That's what I'm wondering too. Even if 1%, if the follow up is very expensive, the initial test might be cheap but overall cost might be very expensive / prohibitive.
    • bluGill 2y ago
      So you are arguing we should just let people die? This is a cancer that is typically detected only after it advances far enough that you will be dead in 6 months (not treatment possible). If we could detect it 2 years sooner it would be treatable and most people could life for many more years. Sure the total cost of a positive will be much higher - between whatever tests to verify it isn't a false positive, and all the treatment it will be a lot more money. However by spending that money many people will live a lot longer. Maybe you don't like any old people, but I often wish I could show my dad my latest project. This test could have saved his life if we had it 15 years ago.
      • cameronh90 2y ago
        Technically we just "let people die" all the time. We could spend more money on road safety (or say, reduce the speed limit to 10 mph) but we don't because the costs are too high. Now, given the relatively common but almost universally fatal nature of pancreatic cancer, any sort of moderately effective screening is probably worth doing, but the argument that if we don't then some people will die isn't very strong.
        • bluGill 2y ago
          That is a very differnt problem.