[skwb]

While it is certainly interesting to hear of new developments for cancer screening, it must be taken in with the proper context. I see a lot of people without medical or public health training fall into the trap of thinking that any sort of screening mechanism is a net positive, without taking into consideration the "costs".

For example, a lot of breast cancer screening has been highly controversial, because of either A) false positive diagnosis B) slowly growing cancers that are too aggressively treated. To properly assess the utility of a cancer screening technique, you need to look at specific long term metrics, such as mortality reduction, that can only be quantified using randomized controlled trials. On the other hand, there's many pitfalls for over treatment. Patients may die during surgery. Biopsy isn't a fun procedure to go through on the receiving end. There's a lot of emotional stress involved. Adverse reactions from chemotherapy/biological agents used to treat the disease. And all this is in the face of the fact that you may die from other causes such as a heart attack.

Certainly I share the optimism with many that we can develop breakthrough cancer screening techniques, but it's irresponsible to let it interfere with rational decision making based on proper studies.

[kaitai]

This is a hugely important comment and given the demographics of HN, I'll bring up prostate cancer as an example. It is important to catch prostate cancer in younger men, as in younger men it tends to be an aggressive cancer and lead to mortality. Paradoxically, in older men, aggressive screening for prostate cancer is bad if you want men to live longer and healthier lives. To oversimplify a bit, old guys with prostate cancer tend to have slow-growing cancers and they will most likely die of something else long before the cancer becomes a problem. Overtreatment of prostate cancer among old guys leads to increased mortality due to the risks of treatment, as well as leading to decreased quality of life due to side effects of surgery. This is why prostate cancer screening guidelines have been revised over the last 3-5 years.

[nradov]

Pathologists say that detailed autopsies of old people almost always turn up some form of cancer, often slow growing. This is true regardless of cause of death. If you live long enough you'll eventually get cancer: it's inevitable.

[DoofusOfDeath]

It's interesting that one argument against early detection (in certain situations) is that patients + medical community can't be trusted to act rationally with the information.

[Gibbon1]

What no one talks about is when you get an indeterminate result. For thyroid tumors that might be as high as 25-30%.

[nradov]

The more important argument is that testing is expensive. As a society we only have limited resources to devote to healthcare.

[DataWorker]

Identifying cancer doesn’t necessitate removal but point taken.

[anonymfus]

Also knowing about cancer decreases quality of life by itself.

[Arelius]

While I agree in part I think the truth is it's more nuanced. Almost uniformly cancer causes stress, saddness and emotional volatility that would not be there otherwise. I have seen it can increase other quality of life factors. Deciding to live in the moment, increase family bonds. Spend more time doing travel and experiences with loved ones. That combined with hope and knowledge of better outcomes I think means that we should consider this with a bit more nuance.

[OrangeMango]

In this context, which age groups are generally considered to be younger men and which are older men?

[jarrad2000]

There's also a lot of confusion due to reported survival rates which are basically always higher if you screen but that does not mean people live any longer (or happier).

https://www.youtube.com/watch?v=gNiORew3uRY