Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Most types of cancer not due to “bad luck” [pdf]

iarc.fr

Post reply on HN
Print view View original

41–50 of 73 posts

Re: Most types of cancer not due to “bad luck” [pdf]

#41

Post by protonfish »

threeseed wrote: post #36
rpedroso wrote: post #11

The author makes a few references to the idea of "scientific consensus", which I find curious. It's a phrase that I tend to cast aside as politically motivated. Politicians in the climate change debate like to point to "scientific consensus" as a way of saying, "look, all these intelligent people whose work we personally don't understand agree, so they must be correct." But one tenant of scientific thought is that tr…

> Perhaps science would be better served by a decreased emphasis on the individuals carrying out scientific research and increased emphasis on the results themselves. No thanks. One of the worst aspects of modern day science right now is that the media et al seems to think it is okay to allow anyone to present counter arguments regardless of their scientific background. This causes problems for the laymen who has no…

The results of one study could mean anything and I agree it should not be emphasized to the public.

However, the term "scientific consensus" makes truth sound like a popularity contest and worse - a popularity contest by people who claim they are better than you. This appeals to the authoritarian nature of people, not their critical nature. It is basically telling the public they aren't allowed to think. It's not only a jerk thing to do, it discourages scientific literacy outside of scientific professionals.

Another problem with the "scientific consensus" is due to its political influence and nebulous definition it is rife for abuse. If there is no rigorous methodology to determine it in an accurate and replicable manner, then it can be whatever someone says it is.

I agree that we need some sort of way of determining scientific validity by taking into account many tests, theory and perpectives, but "Scientific consensus" (whatever that is) is not it.

Re: Most types of cancer not due to “bad luck” [pdf]

#42

Post by gms7777 »

avnfish wrote: post #17

I'm pretty confused by the term 'luck' in these papers. Surely 'random mutation' is exactly how cancer propagates in all cases? Risk factors coexist with 'luck'. The chance of suffering a cancerous mutation is like rolling a dice, and risk factors are the equivalent of the number of dice being rolled. It's not a question of 'OR', it's a question of 'AND'. E.g.: You're a smoker who develops lung cancer: you are 'unluc…

I haven't read the Vogelstein paper yet, but from the abstract it seems that when its talking about 'luck', its talking about errors in DNA replication. The rate of these errors is pretty constant in healthy cells (about 1 per duplication), so its pretty much a matter of luck whether you acquire a mutation in a place that matters or a place that doesn't, and it doesn't really matter who you are or where you are. He seems to be contrasting this to other mechanisms that cause mutations, like chemicals, radiation, or viruses. Sure there is 'luck' involved at the individual level once you've been exposed, but the point is if you reduce exposure across the population, you reduce incidence rates. With DNA replication, there isn't anything you can do to reduce incidence rates.

Re: Most types of cancer not due to “bad luck” [pdf]

#43

Post by StavrosK »

melling wrote: post #16
SquareWheel wrote: post #3

Earlier quoted context omitted.

It's not as simple as that. Most "indecisiveness" that appears to come from science is from different studies being taken out of context, or poor media reporting. Most wild claims you see aren't from the researchers themselves. See Steven Novella's recent blog post on this subject. http://theness.com/neurologicablog/index.php/scott-adams-on-...

I'm not sure that matters. It's ok to eat cholesterol now, right? All these "mistakes" give science a black eye. We've already got a Climate Change trustworthyness problem and for some reason people don't trust vaccines, mostly educated people. As a nation, we refused to fund both the Hubble and the Supercollider, which would have been bigger than CERN. It's probably time that we stopped making excuses and think of a…

I think it's more of a problem of misaligned incentives rather than the method itself. There's a lot of room for politics, ass-covering, etc. Studies that fail to replicate something are shelved, even though they're useful information. Studies that indicate a negative, ditto. Studies are "nudged" to show something so the author can show that it wasn't a complete waste of time, etc.

They're understandable, but they're bad for science.

Re: Most types of cancer not due to “bad luck” [pdf]

#44

Post by defenestration »

jkot wrote: post #40
defenestration wrote: post #22

Earlier quoted context omitted.

There is a great difference between the incidence of prostate cancer and the death rate from it. Prostate cancer is currently diagnosed in 15 to 20% of men during their lifetime, but the lifetime risk of death from prostate cancer is only 3%. Source: European prostate cancer guideline (page 45): http://www.uroweb.org/gls/pdf/09%20Prostate%20Cancer_LRLV2.p...

Interesting, that is original paper, referenced from article above: http://www.uroweb.org/gls/pdf/09%20Prostate%20Cancer_LRLV2.p... > Tumour grade is clearly significant, with very low survival rates for grade 3 tumours. Although the 10-year cancer-specific rate is equally good (87%) for grade 1 and 2 tumours, the latter have a significantly higher progression rate, with 42% of patients with these tumours developing…

You can become old with localized prostate cancer. You have to make the choice if you want to live with some uncertainty (the cancer could progress into metastases) or to get treatment now. The downside of treatments, like surgery and radiation, is the risk of becoming impotent and/or incontinent.

Re: Most types of cancer not due to “bad luck” [pdf]

#45

Post by kgwgk »

jkot wrote: post #10
regularfry wrote: post #7

Earlier quoted context omitted.

Is it a myth that prostate cancer is something you die with, rather than die of?

I dont know. But in Europe preventive checks are highly recommended (and covered).

Highly recommended by whom? At least PSA screening does not seem to be "highly" recommended.

http://www.erspc.org/prostate-cancer/erspc-background/#what-...

The council recommendation on cancer screening for the European Union accepted in 2003 states that PSA testing for prostate cancer, though promising, does not meet the criteria of having proved to decrease the cancer-specific mortality, or well known and acceptable benefits and risks, as well as cost-effectiveness. Therefore, prostate cancer screening is not recommended. The statement emphasizes the importance of the randomized trials and specifically cites the ERSPC in this respect.

This position is consistent with the recommendations of an expert panel organized by the World Health Organization (WHO) and the International Cancer Union, which stated that sufficient evidence showing the benefits of prostate cancer screening in terms of mortality reduction is still to emerge. Therefore, offering screening as part of health care policy can not be recommended without further evidence.

Similar conclusions about withholding screening due to lack of evidence have also been reached in assessments of the U.S. Preventive Services Task Group and the U.S. National Cancer Institute.

Nevertheless, screening does take place even if it is not part of the policy. This is done on the basis of judgment and the responsibility of individual physicians and their patients, who may in some circumstances, regard the possibility of benefit as more important than lack of demonstrated effectiveness.

http://www.cancerscreening.nhs.uk/prostate/prostate-patient-...

The PSA test, which can give an early indication of prostate cancer, is available to you if you want to be tested. However, experts disagree on how useful the PSA test is. This is why there is a lot of research and why there is no national screening programme for prostate cancer in the United Kingdom (UK).

Re: Most types of cancer not due to “bad luck” [pdf]

#46

Post by FrojoS »

orting wrote: post #38
calinet6 wrote: post #20

This shows a severe misunderstanding of statistics. The original paper (here: http://www.sciencemag.org/content/347/6217/78.abstract -- the abstract is enough to deduce the conclusion) is a simple statistical analysis of mutation probability in certain cell types. It's basically saying that many cancers are not necessarily influenced by external factors and can be predicted by nothing more than the number of cell div…

A specific critique raised in the press release from IARC is that the study has an "emphasis on very rare cancers (e.g. osteosarcoma, medulloblastoma) that together make only a small contribution to the total cancer burden." and that it "excludes [...] common cancers for which incidence differs substantially between populations and over time." So it sounds like the generalization hinted at in the abstract shows a big…

I put the full paper in pastebin: http://pastebin.com/GH1ZY8Zx

Didnt read it, so not sure if its sufficiently understandable without the figures. Prob not.

Re: Most types of cancer not due to “bad luck” [pdf]

#47

Post by rjurney »

orting wrote: post #38
calinet6 wrote: post #20

This shows a severe misunderstanding of statistics. The original paper (here: http://www.sciencemag.org/content/347/6217/78.abstract -- the abstract is enough to deduce the conclusion) is a simple statistical analysis of mutation probability in certain cell types. It's basically saying that many cancers are not necessarily influenced by external factors and can be predicted by nothing more than the number of cell div…

A specific critique raised in the press release from IARC is that the study has an "emphasis on very rare cancers (e.g. osteosarcoma, medulloblastoma) that together make only a small contribution to the total cancer burden." and that it "excludes [...] common cancers for which incidence differs substantially between populations and over time." So it sounds like the generalization hinted at in the abstract shows a big…

You're right. You might say "most cancers are caused by bad luck," and across the set of types of cancers... that might be the case. But if you were to say, "Most cases of cancer are caused by behavioral or environmental factors" you'd be saying something entirely different.

Re: Most types of cancer not due to “bad luck” [pdf]

#48

Post by defenestration »

kgwgk wrote: post #45
jkot wrote: post #10

Earlier quoted context omitted.

I dont know. But in Europe preventive checks are highly recommended (and covered).

Highly recommended by whom? At least PSA screening does not seem to be "highly" recommended. http://www.erspc.org/prostate-cancer/erspc-background/#what-... The council recommendation on cancer screening for the European Union accepted in 2003 states that PSA testing for prostate cancer, though promising, does not meet the criteria of having proved to decrease the cancer-specific mortality, or well known and acceptab…

I agree, let's take a look at the numbers.

You need to: > screen 1410 men > then take a biopt from 340 of them > then diagnose 82 men with prostate cancer > to save 1 man from dying from prostate cancer

Source (Dutch General Practitioners Organization): https://www.nhg.org/nhg-standpunt-prostaatkankerscreening-vo...

Re: Most types of cancer not due to “bad luck” [pdf]

#49

Post by rpedroso »

threeseed wrote: post #36
rpedroso wrote: post #11

The author makes a few references to the idea of "scientific consensus", which I find curious. It's a phrase that I tend to cast aside as politically motivated. Politicians in the climate change debate like to point to "scientific consensus" as a way of saying, "look, all these intelligent people whose work we personally don't understand agree, so they must be correct." But one tenant of scientific thought is that tr…

> Perhaps science would be better served by a decreased emphasis on the individuals carrying out scientific research and increased emphasis on the results themselves. No thanks. One of the worst aspects of modern day science right now is that the media et al seems to think it is okay to allow anyone to present counter arguments regardless of their scientific background. This causes problems for the laymen who has no…

I agree that armchair "expert opinion" is a significant problem at this time (see Harry Collins, "Are we all scientific experts now?"). However, I'm not sure I see how a social emphasis on evidence over authority would invite more of this.

Collins, for instance, traces this problem to misplaced feelings of expertise. He believes we should "elevate science to a special position in our society." I mean to suggest that if we focus less on authority ("x says this, x is an expert, x is true") and more on science ("experiment y is evidence that z"), then this kind of layperson interjection would be excluded from social discourse.

Re: Most types of cancer not due to “bad luck” [pdf]

#50

Post by smtddr »

FrojoS wrote: post #46
orting wrote: post #38

Earlier quoted context omitted.

A specific critique raised in the press release from IARC is that the study has an "emphasis on very rare cancers (e.g. osteosarcoma, medulloblastoma) that together make only a small contribution to the total cancer burden." and that it "excludes [...] common cancers for which incidence differs substantially between populations and over time." So it sounds like the generalization hinted at in the abstract shows a big…

I put the full paper in pastebin: http://pastebin.com/GH1ZY8Zx Didnt read it, so not sure if its sufficiently understandable without the figures. Prob not.

What's HN's stance on posting a paywalled article to pastebin like this? If I were to guess, I'd think this to be frowned upon.
Post reply on HN