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0 pointsrdedev2y ago0 comments

I think the consensus on cancer screening is stil not fully there? Came across this video by a cardiologist a long time ago

https://youtu.be/yNzQ_sLGIuA?si=fUttSVFQjsrIqc-p

I guess the main gist is that screening is not completely benign and a positive screen might lead to more interventions for what in the end could just be a benign tumor. Then there's the other point of detecting it late in life. Like treatment for cancer might not make much sense if you are already 89 years old

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haltingproblem2y ago

This is the negative expectation part of most medical screening that most analyses miss.

- Medical screenings themselves have iatrogenic effects,

- the false positives interventions resulting from screenings have further negative effects and

- finally the true positive interventions don't necessarily prolong life.

All in all very difficult (confounding) tradeoffs that are impossible to quantify and understand especially when the cultural pressure is to do something.

arisAlexis2y ago

Do you really believe your third point? That most medical interventions for cancer do not prolong life? Or the word necessarily means your argument is null like "not all interventions prolong life". Yeah , we knew that already. It's never 100%.

haltingproblem2y ago

Sorry for the delay in responding.

I actually do and most of it based on what I have have directly experienced with what, especially older doctors, counsel their patients.

There is a lot of literature on how doctors die [1], which also drives my beliefs.

I am also influenced and how weak the statistical significance is on evidence based literature on interventions and how often the interventions are difficult to replicate.

As always, please do your own research :)

1- https://www.thehappymd.com/blog/bid/295228/how-doctors-die

csours2y ago

> most medical interventions for cancer do not prolong life

Specifically, medical interventions for cancer AS A RESULT of some types of screening do not prolong life.

Medical interventions for symptomatic cancer, and some types of screening, certainly do prolong life, and quality of life.

There are so many confounding factors in this it's hard to do something like a pareto breakdown, but it would certainly be interesting to see.

NoZebra120vClip2y ago

I'd rather die of cancer than die of chemotherapy.

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haltingproblem2y ago

This is the negative expectation part of most medical screening that most analyses miss.

- Medical screenings themselves have iatrogenic effects,

- the false positives interventions resulting from screenings have further negative effects and

- finally the true positive interventions don't necessarily prolong life.

All in all very difficult (confounding) tradeoffs that are impossible to quantify and understand especially when the cultural pressure is to do something.

arisAlexis2y ago

haltingproblem2y ago

Sorry for the delay in responding.

I actually do and most of it based on what I have have directly experienced with what, especially older doctors, counsel their patients.

There is a lot of literature on how doctors die [1], which also drives my beliefs.

I am also influenced and how weak the statistical significance is on evidence based literature on interventions and how often the interventions are difficult to replicate.

As always, please do your own research :)

1- https://www.thehappymd.com/blog/bid/295228/how-doctors-die

csours2y ago

> most medical interventions for cancer do not prolong life

Specifically, medical interventions for cancer AS A RESULT of some types of screening do not prolong life.

Medical interventions for symptomatic cancer, and some types of screening, certainly do prolong life, and quality of life.

There are so many confounding factors in this it's hard to do something like a pareto breakdown, but it would certainly be interesting to see.

NoZebra120vClip2y ago

I'd rather die of cancer than die of chemotherapy.

1 more reply

j / k navigate · click thread line to collapse