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That initial statement may have been a bit too strong, but I did clarify it later in the same comment: > While we have some proactive screening for some types of cancer, the status quo for many types of cancer/patients is “wait until the cancer has spread enough that the patient is experiencing significant symptoms, with no systematic way to detect cancer early.” Maybe it depends on where you are, but where I am (Vancouver BC, Canada), the above is true. Proactive cancer screening is quite limited here. I believe it's limited to screening for cervical, breast, colon and prostate cancer, plus lung cancer for 55+ year old smokers who smoked for at least 20 years. And for even those specific cancers that are screened for, availability is limited by risk factors like age, e.g. you can't get screened for colon cancer until you're 50, that sort of thing. There are so, so many other types of cancer and non-cancer diseases/conditions that we do not screen for at all. Plus, even for the cancers we do have screening for, it's often not frequent enough to catch more aggressive variants early - a lot of these screenings are only once every ~2-5 years. The idea of, say, proactively taking MRIs, blood panels, etc. on people, looking for early stage cancer (and other conditions) throughout the body is not something that's available. You can't even get an annual physical with a family doctor anymore, there's only screening for a handful of specific diseases, and only once you reach certain ages/risk factors. Cancer screening starts a bit earlier for women, due to higher risk of breast and cervical cancer, but if you're a man under 50 in BC, you're really never getting any sort of medical test done ever (even simple things like blood panels) unless you go in to a doctor's office for a specific condition. I have MANY friends and family members who've been diagnosed with cancer in Canada, and almost none of it has been caught in regular screening, because the screening is so limited, its almost always been caught by the cancer spreading enough that the person goes to their doctor due to symptoms. |
Screening intervals are based on doubling time.
> The idea of, say, proactively taking MRIs, blood panels, etc. on people, looking for early stage cancer (and other conditions) throughout the body is not something that's available.
You can pay out of pocket for a “screening MRI” in BC but from my clinical practice the yield is dubious.
> You can't even get an annual physical with a family doctor anymore,
Evidence has shown the physical is useless.
> there's only screening for a handful of specific diseases, and only once you reach certain ages/risk factors
Screening needs pretest probability and a diagnostic test with sufficient accuracy. It simply does not exist for most cancers. Trials are underway for new tests like cfDNA but in 2024 there aren’t any validated options.