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Are we screening too much for skin cancer? It's complicated

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Re: Are we screening too much for skin cancer? It's complicated

#3

Post by bricemo »

This is a complicated space to get right. Prostate cancer is the opposite: The government used to screen for it (PSA blood test) and so people would see their doctor at stage 1 or 2 cancer, when it can be easily tested. But the problem was that the positivity rate was about 45:1, and the test is too expensive at that scale. So now PSA tests are not routine. As a result, people are now coming in to their doctors with prostate cancer at stage 3 or 4. Might be the right choice for society, but the wrong choice for the individual.

Re: Are we screening too much for skin cancer? It's complicated

#4

Post by google234123 »

bricemo wrote: post #3

This is a complicated space to get right. Prostate cancer is the opposite: The government used to screen for it (PSA blood test) and so people would see their doctor at stage 1 or 2 cancer, when it can be easily tested. But the problem was that the positivity rate was about 45:1, and the test is too expensive at that scale. So now PSA tests are not routine. As a result, people are now coming in to their doctors with…

It's definitely complicated because most of these older men with stage 1/2 prostate cancer will not actually die from it since it's so slow. However, getting the treatment for it leaves a huge number with erectile dysfunction or other issues.

Is it really worth screening/treating a disease with a small chance to kill you if that treatment has a huge chance to make you impotent?

Re: Are we screening too much for skin cancer? It's complicated

#5

Post by im3w1l »

google234123 wrote: post #4
bricemo wrote: post #3

This is a complicated space to get right. Prostate cancer is the opposite: The government used to screen for it (PSA blood test) and so people would see their doctor at stage 1 or 2 cancer, when it can be easily tested. But the problem was that the positivity rate was about 45:1, and the test is too expensive at that scale. So now PSA tests are not routine. As a result, people are now coming in to their doctors with…

It's definitely complicated because most of these older men with stage 1/2 prostate cancer will not actually die from it since it's so slow. However, getting the treatment for it leaves a huge number with erectile dysfunction or other issues. Is it really worth screening/treating a disease with a small chance to kill you if that treatment has a huge chance to make you impotent?

Depends on your values. Some people may think it's worth it for them, and that's valid.

Re: Are we screening too much for skin cancer? It's complicated

#6

Post by c152driver »

bricemo wrote: post #3

This is a complicated space to get right. Prostate cancer is the opposite: The government used to screen for it (PSA blood test) and so people would see their doctor at stage 1 or 2 cancer, when it can be easily tested. But the problem was that the positivity rate was about 45:1, and the test is too expensive at that scale. So now PSA tests are not routine. As a result, people are now coming in to their doctors with…

Complicated indeed. For prostate cancer, the pendulum really seems to have swung in the direction of underdiagnosing. My dad was doctoring for several months with urinary tract systems. The doctor flat out told him "you don't have prostate cancer". It wasn't until he sought out a second opinion several months later that he was diagnosed with stage 4 prostate cancer.

Re: Are we screening too much for skin cancer? It's complicated

#7

Post by alexfromapex »

As someone who had an early melanoma detected and removed, I disagree with this. What I find frustrating is that they only attribute UV damage as the cause when it's probably a combination of UV damage and diet, or repetitive extreme UV damage combined with bad diet, etc.

Re: Are we screening too much for skin cancer? It's complicated

#9

Post by dukeofdoom »

I once got stuck walking on a board walk behind an elderly man in a g-string european type swimwear in Hawaii. Looking at his extremely wrinkled ass, I quickly realized this man was addicted to sun bathing. Coming from a northern part of the world, did not know that was a thing. He looked about 70, formerly a white guy. So perhaps some people can develop some way of dealing with skin damage from the sun. The man needed to be studied by science. His immune system was trained to kill cancer cells daily.
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