5 ms·

Cancer is surging, bringing a debate about whether to look for it

81 points by brandonb 11mo ago

https://archive.ph/NIptp https://archive.ph/NIptp

mv4 11mo ago
https://archive.ph/NIptp https://archive.ph/NIptp
stefantalpalaru 11mo ago
[dead]
adventured 11mo ago
It's from a dramatic rise in inactive lifestyles by younger people and a lot of sitting, with the predictable consequences. Behavior which would have been far less common before mass adoption of video games and personal computing in the home, and then everybody sitting/laying around their homes with their smartphones. Young people go out less, they have a lot less sex, they're far less social in-person. It all goes together. These people under 50 were the first generation to sit around at home for long periods of time playing video games. The NES came out in 1985-86 in the US and home video gaming has been mass adopted since. From there add on the full adoption of sitting down at a computer for work in offices across the 1980s and 1990s. Then throw in the full adoption of home computing in the 1990s with Win3 & Win95 + GUI. And for the past 20 years, throw in the smartphone. It's the sitting primarily, hours and hours of it every day.
- JumpCrisscross 11mo ago
  > It's the sitting primarily, hours and hours of it every day ...do you have a source for this causative link? It would seem like it's highly testable.
- b212 11mo ago
  I don’t drink, I never smoked, I eat clean, I run, I swim, I go to the gym. But I’m also at my desk for 13 hours a day on average and I think it will kill me one day. Trying to stand as much as possible but it’s not always possible,
helph67 11mo ago
Consuming foods rich in antioxidants may help. "Research suggests that free radical molecules can add to the risk of health issues linked to aging. Some examples are heart disease, age-related macular degeneration, Alzheimer's disease and cancer." https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/add-antioxidants-to-your-diet/art-20546814 https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...
- pfdietz 11mo ago
  On the other hand, it's known that consuming the antioxidant vitamin E actually promotes the progression of lung cancer. Cancer cells are under oxidative stress so antioxidants can help them survive and grow. https://www.lung.org/blog/antioxidants-lung-cancers https://www.lung.org/blog/antioxidants-lung-cancers
  - clumsysmurf 11mo ago
    The Vitamin E / NAC relationship are interesting. As far as I understand, there needs to be a balance of anti-oxidants (C, E, Selenium, etc). To make it worse there are so many formulations of Vitamin E you can buy (tocopherols, tocotrienols, etc). Sometimes its hard to tell from the studies what forms exactly were being used. You may also find this interesting: "NRF2 activation is a predictor of poor clinical outcomes in lung cancer. Given the widespread use of NRF2-inducing compounds such as resveratrol and sulforaphane, these findings raise important concerns about their safety in individuals at risk for or living with cancer." https://link.springer.com/article/10.1007/s11357-025-01736-0 https://link.springer.com/article/10.1007/s11357-025-01736-0 Many people eat high-sulforaphane containing foods for health benefits. And finally from last week https://newatlas.com/diet-nutrition/vitamin-c-air-pollution-damage/ https://newatlas.com/diet-nutrition/vitamin-c-air-pollution-... This was about 1000mg / day for humans.
  - neuronic 11mo ago
    Just goes to show that biology is WAY more complicated than "if you want to prevent X then do Y" - especially at microbilogical scale. Genes influence each other for example, so by up- or downregulating stuff you are interfering in a highly complex, non-linear system with complex consequences. Just look at this example of a gene regulation network: https://www.researchgate.net/figure/Different-visualizations-of-gene-regulatory-networks-A-The-protein-protein-interaction_fig3_368589668 https://www.researchgate.net/figure/Different-visualizations...
JumpCrisscross 11mo ago
"The rise in early-onset cancer incidence does not consistently signal a rise in the occurrence of clinically meaningful cancer. While some of the increase in early-onset cancer is likely clinically meaningful, it appears small and limited to a few cancer sites. Much of the increase appears to reflect increased diagnostic scrutiny and overdiagnosis. Interpreting rising incidence as an epidemic of disease may lead to unnecessary screening and treatment while also diverting attention from other more pressing health threats in young adults" [1]. [1] https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2839347 https://jamanetwork.com/journals/jamainternalmedicine/articl...
pcdoodle 11mo ago
[dead]
makestuff 11mo ago
The rise in the preventative screening centers (such as prenuvo) that offer whole body MRIs will be interesting. The research seems split on if it is worth it or just causes unneeded worry. Obviously if you catch something early then that is great, but there are a lot of people who have a ton of followup testing only to find out there is no issue. There are also limitations with the level of detail a full body MRI can capture. I could see it becoming similar to a colonoscopy where you get it like when you turn 30 or something and then every 5-10 years after that.
- deleted 11mo ago
  [deleted]
- pharaohgeek 11mo ago
  As part of my post-cancer screening, I have received a full-body MRI every year since 2017. In 2024, it discovered pancreatic cancer. Grateful for those years where it found nothing, but even MORE grateful when it did catch something!
nfw2 11mo ago
"Some cancer specialists counter these concerns, saying the surge in diagnoses is primarily a surge in detecting cancers that did not need to be found..." This seems excessively paternalistic. If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things, it leaves patients with no way to discover life-altering information about their own health.
- kulahan 11mo ago
  There is cancer in your body every single day. Your immune system handles it just fine. There is an explicit difference between cancer that needs treating and cancer that should be ignored because it's a waste of time and resources to treat. You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason. We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.
  - poszlem 11mo ago
    That's kind of like saying that there is diabetes in your body every single day, and your body handles it just fine by producing insulin. Obviously that statement is nonsensical and essentially devoid of any useful insight. I'm not even going to comment on this: "You're not a doctor, you're not qualified to tell the difference", because this is such a weird statement that I don't understand how anybody could utter it on this website. If that is your standard for critical thinking, you are paving the way for anti-science rhetoric to dominate public discourse. Treat people like stupid idiots if you want but then don't be surprised by the way they vote in elections as a result.
    - kulahan 11mo ago
      No, it’s nothing like that. I won’t even get into the irony of you not realizing that not all forms of diabetes are related to insulin (diabetes insipidus) while simultaneously claiming that you don’t need to be a doctor to be qualified enough to make complex medical decisions. In the first place, the analogy is wrong. You need insulin, you need blood sugar. Both SHOULD be present. Cancer never SHOULD be present, it just happens to be there often, like any other thing your body clears out. Edit: the word “diabetes” originally comes from a word meaning “to pass through”. Literally the only thing linking all diabetic conditions is needing to pee a lot
samdoesnothing 11mo ago
Surely it has nothing to do with the proliferation of chemicals and microplastics into the ecosystem, water, food, etc. That would be absurd, after all, a Monsanto-sponsored study found that their pesticides are totally safe.
jmclnx 11mo ago
>The problem is that it is impossible to know if someone’s cancer will be deadly or not. And that is the issue, I know 2 people who developed cancers when they were around 40, one died, the other person survived but had to be treated. So we close our eyes and hope for the best ?
- bryanlarsen 11mo ago
  And I'm sure neither were one of the cancers discussed in the article as candidates for lower screening. Nobody's suggesting we stop looking for lung cancer or any of the other many deadly ones. OTOH, increased screening for thyroid cancer had 0 impact on life expectancy in South Korea.
  - creer 11mo ago
    They ARE suggesting such things (including forms of "not looking") even for deadly ones. In these cases, it is couched in terms of what follow-up is "deemed necessary" (see later) depending on stage classification of that cancer. There is a range of responses that's possible and new research and procedure advancement coming online on a 5-yearly basis in addition to variations in capabilities from hospital to hospital - so a pretty volatile environment - yet the staging recommendation gets changed often based on what health care professionals estimate they can sustain society-wide - i.e. manpower - rather than what might be optimal from a survival point of view for that patient. To pick one specific example, skin cancer visual screening seems currently recommended on a frequency based not on the speed of evolution of, say, melanoma - which can start and evolve pretty fast -, but on the manpower availability of dermatologists.
jarmitage 11mo ago
The term is incidentaloma https://en.wikipedia.org/wiki/Incidental_imaging_finding https://en.wikipedia.org/wiki/Incidental_imaging_finding
andy_ppp 11mo ago
Very interesting breakdown from Medlife crisis discussing this: https://youtu.be/BJ9soFmzYO8 https://youtu.be/BJ9soFmzYO8
dekhn 11mo ago
Medical reasoning is complex. It typically needs to consider second and third order effects (typically, how the public responds to a policy needs to be considered when updating the policy). It can't simply attempt to maximize the global health utility function (ethics, budgets, politics, and human behavior all get in the way). If your reaction to something like this is an offhand "why don't you just...", or "experts don't matter", or "my grandma told me not to eat sugar because it feeds cancer", please, take a deep breath, and think twice before starting to argue with folks about this.
tsoukase 11mo ago
The term cancer refers to hundreds of different tumors with widely various prognosis. The type and especially the differentiation play the crucial role. Such statistics are difficult to present. In the case of autism the scientists believed that it increased lately but more careful research showed that this was due to early diagnosis.
stevenalowe 11mo ago
“Dr. Welch said the number of unnecessary diagnoses could be lessened if doctors did less routine testing — and if doctors held back from pursuing every abnormality in asymptomatic patients.” I pity this doctor’s patients
qgin 11mo ago
The argument against screening is kind of like if you had a really inept fire department that ended up crashing the firetruck into other vehicles and buildings every time they were dispatched... and instead of figuring out how to have the fire department respond to calls in a better and safer way, you ban smoke detectors because then the fire department will only be called after buildings are confirmed to be already engulfed in flames.

81 points by brandonb 11mo ago

https://archive.ph/NIptp https://archive.ph/NIptp

mv4 11mo ago

https://archive.ph/NIptp https://archive.ph/NIptp

stefantalpalaru 11mo ago

[dead]

adventured 11mo ago

It's from a dramatic rise in inactive lifestyles by younger people and a lot of sitting, with the predictable consequences. Behavior which would have been far less common before mass adoption of video games and personal computing in the home, and then everybody sitting/laying around their homes with their smartphones. Young people go out less, they have a lot less sex, they're far less social in-person. It all goes together. These people under 50 were the first generation to sit around at home for long periods of time playing video games. The NES came out in 1985-86 in the US and home video gaming has been mass adopted since. From there add on the full adoption of sitting down at a computer for work in offices across the 1980s and 1990s. Then throw in the full adoption of home computing in the 1990s with Win3 & Win95 + GUI. And for the past 20 years, throw in the smartphone. It's the sitting primarily, hours and hours of it every day.

JumpCrisscross 11mo ago
> It's the sitting primarily, hours and hours of it every day ...do you have a source for this causative link? It would seem like it's highly testable.
b212 11mo ago
I don’t drink, I never smoked, I eat clean, I run, I swim, I go to the gym. But I’m also at my desk for 13 hours a day on average and I think it will kill me one day. Trying to stand as much as possible but it’s not always possible,

helph67 11mo ago

Consuming foods rich in antioxidants may help. "Research suggests that free radical molecules can add to the risk of health issues linked to aging. Some examples are heart disease, age-related macular degeneration, Alzheimer's disease and cancer." https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/add-antioxidants-to-your-diet/art-20546814 https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...

pfdietz 11mo ago
On the other hand, it's known that consuming the antioxidant vitamin E actually promotes the progression of lung cancer. Cancer cells are under oxidative stress so antioxidants can help them survive and grow. https://www.lung.org/blog/antioxidants-lung-cancers https://www.lung.org/blog/antioxidants-lung-cancers
- clumsysmurf 11mo ago
  The Vitamin E / NAC relationship are interesting. As far as I understand, there needs to be a balance of anti-oxidants (C, E, Selenium, etc). To make it worse there are so many formulations of Vitamin E you can buy (tocopherols, tocotrienols, etc). Sometimes its hard to tell from the studies what forms exactly were being used. You may also find this interesting: "NRF2 activation is a predictor of poor clinical outcomes in lung cancer. Given the widespread use of NRF2-inducing compounds such as resveratrol and sulforaphane, these findings raise important concerns about their safety in individuals at risk for or living with cancer." https://link.springer.com/article/10.1007/s11357-025-01736-0 https://link.springer.com/article/10.1007/s11357-025-01736-0 Many people eat high-sulforaphane containing foods for health benefits. And finally from last week https://newatlas.com/diet-nutrition/vitamin-c-air-pollution-damage/ https://newatlas.com/diet-nutrition/vitamin-c-air-pollution-... This was about 1000mg / day for humans.
- neuronic 11mo ago
  Just goes to show that biology is WAY more complicated than "if you want to prevent X then do Y" - especially at microbilogical scale. Genes influence each other for example, so by up- or downregulating stuff you are interfering in a highly complex, non-linear system with complex consequences. Just look at this example of a gene regulation network: https://www.researchgate.net/figure/Different-visualizations-of-gene-regulatory-networks-A-The-protein-protein-interaction_fig3_368589668 https://www.researchgate.net/figure/Different-visualizations...

JumpCrisscross 11mo ago

"The rise in early-onset cancer incidence does not consistently signal a rise in the occurrence of clinically meaningful cancer. While some of the increase in early-onset cancer is likely clinically meaningful, it appears small and limited to a few cancer sites. Much of the increase appears to reflect increased diagnostic scrutiny and overdiagnosis. Interpreting rising incidence as an epidemic of disease may lead to unnecessary screening and treatment while also diverting attention from other more pressing health threats in young adults" [1]. [1] https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2839347 https://jamanetwork.com/journals/jamainternalmedicine/articl...

pcdoodle 11mo ago

[dead]

makestuff 11mo ago

The rise in the preventative screening centers (such as prenuvo) that offer whole body MRIs will be interesting. The research seems split on if it is worth it or just causes unneeded worry. Obviously if you catch something early then that is great, but there are a lot of people who have a ton of followup testing only to find out there is no issue. There are also limitations with the level of detail a full body MRI can capture. I could see it becoming similar to a colonoscopy where you get it like when you turn 30 or something and then every 5-10 years after that.

deleted 11mo ago
[deleted]
pharaohgeek 11mo ago
As part of my post-cancer screening, I have received a full-body MRI every year since 2017. In 2024, it discovered pancreatic cancer. Grateful for those years where it found nothing, but even MORE grateful when it did catch something!

nfw2 11mo ago

"Some cancer specialists counter these concerns, saying the surge in diagnoses is primarily a surge in detecting cancers that did not need to be found..." This seems excessively paternalistic. If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things, it leaves patients with no way to discover life-altering information about their own health.

kulahan 11mo ago
There is cancer in your body every single day. Your immune system handles it just fine. There is an explicit difference between cancer that needs treating and cancer that should be ignored because it's a waste of time and resources to treat. You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason. We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.
- poszlem 11mo ago
  That's kind of like saying that there is diabetes in your body every single day, and your body handles it just fine by producing insulin. Obviously that statement is nonsensical and essentially devoid of any useful insight. I'm not even going to comment on this: "You're not a doctor, you're not qualified to tell the difference", because this is such a weird statement that I don't understand how anybody could utter it on this website. If that is your standard for critical thinking, you are paving the way for anti-science rhetoric to dominate public discourse. Treat people like stupid idiots if you want but then don't be surprised by the way they vote in elections as a result.
  - kulahan 11mo ago
    No, it’s nothing like that. I won’t even get into the irony of you not realizing that not all forms of diabetes are related to insulin (diabetes insipidus) while simultaneously claiming that you don’t need to be a doctor to be qualified enough to make complex medical decisions. In the first place, the analogy is wrong. You need insulin, you need blood sugar. Both SHOULD be present. Cancer never SHOULD be present, it just happens to be there often, like any other thing your body clears out. Edit: the word “diabetes” originally comes from a word meaning “to pass through”. Literally the only thing linking all diabetic conditions is needing to pee a lot

samdoesnothing 11mo ago

Surely it has nothing to do with the proliferation of chemicals and microplastics into the ecosystem, water, food, etc. That would be absurd, after all, a Monsanto-sponsored study found that their pesticides are totally safe.

jmclnx 11mo ago

>The problem is that it is impossible to know if someone’s cancer will be deadly or not. And that is the issue, I know 2 people who developed cancers when they were around 40, one died, the other person survived but had to be treated. So we close our eyes and hope for the best ?

bryanlarsen 11mo ago
And I'm sure neither were one of the cancers discussed in the article as candidates for lower screening. Nobody's suggesting we stop looking for lung cancer or any of the other many deadly ones. OTOH, increased screening for thyroid cancer had 0 impact on life expectancy in South Korea.
- creer 11mo ago
  They ARE suggesting such things (including forms of "not looking") even for deadly ones. In these cases, it is couched in terms of what follow-up is "deemed necessary" (see later) depending on stage classification of that cancer. There is a range of responses that's possible and new research and procedure advancement coming online on a 5-yearly basis in addition to variations in capabilities from hospital to hospital - so a pretty volatile environment - yet the staging recommendation gets changed often based on what health care professionals estimate they can sustain society-wide - i.e. manpower - rather than what might be optimal from a survival point of view for that patient. To pick one specific example, skin cancer visual screening seems currently recommended on a frequency based not on the speed of evolution of, say, melanoma - which can start and evolve pretty fast -, but on the manpower availability of dermatologists.

jarmitage 11mo ago

The term is incidentaloma https://en.wikipedia.org/wiki/Incidental_imaging_finding https://en.wikipedia.org/wiki/Incidental_imaging_finding

andy_ppp 11mo ago

Very interesting breakdown from Medlife crisis discussing this: https://youtu.be/BJ9soFmzYO8 https://youtu.be/BJ9soFmzYO8

dekhn 11mo ago

Medical reasoning is complex. It typically needs to consider second and third order effects (typically, how the public responds to a policy needs to be considered when updating the policy). It can't simply attempt to maximize the global health utility function (ethics, budgets, politics, and human behavior all get in the way). If your reaction to something like this is an offhand "why don't you just...", or "experts don't matter", or "my grandma told me not to eat sugar because it feeds cancer", please, take a deep breath, and think twice before starting to argue with folks about this.

tsoukase 11mo ago

The term cancer refers to hundreds of different tumors with widely various prognosis. The type and especially the differentiation play the crucial role. Such statistics are difficult to present. In the case of autism the scientists believed that it increased lately but more careful research showed that this was due to early diagnosis.

stevenalowe 11mo ago

“Dr. Welch said the number of unnecessary diagnoses could be lessened if doctors did less routine testing — and if doctors held back from pursuing every abnormality in asymptomatic patients.” I pity this doctor’s patients

qgin 11mo ago

The argument against screening is kind of like if you had a really inept fire department that ended up crashing the firetruck into other vehicles and buildings every time they were dispatched... and instead of figuring out how to have the fire department respond to calls in a better and safer way, you ban smoke detectors because then the fire department will only be called after buildings are confirmed to be already engulfed in flames.