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

Most cancer screenings don’t extend life, study finds

cnn.com

Post reply on HN
Print view View original

101–110 of 149 posts

Re: Most cancer screenings don’t extend life, study finds

#101

Post by michael1999 »

arisAlexis wrote: post #82

There is a really weird connotation with this: if when malignancy is found and then actions are taken and when it's found earlier actions are taken earlier but they still don't survive means that when you treat a cancer early is the same as treating it late. But that is contrary to all studies ever done. So either there is some mistake or stage I with stage 3 cancer have the same survival. Look like someone fucked up…

It could also mean there are other negative forces balancing out the positive forces. Negative outcomes for broad screening include.

- Early testing means more visits to the hospitals/clinics. Those are famously dangerous places to get sick.

- False positives mean unneeded treatment. That can shorten your life.

- Finding things earlier also means earlier treatment. That can kill you. Every trip to a hospital means a non-zero risk of catching MRSA and other nasties.

- Some things would be handled by the immune system anyway. The treatment might provide no benefit over an ignorant outcome.

I also find it easy to believe that among all the oncologists and hospitals, some of them might be at best neutral, or even net-negative in mortality and morbidity. This is about the whole population, not just leading units at famous hospitals. There are doctors out there with the ethics of a bent mechanic.

Re: Most cancer screenings don’t extend life, study finds

#102

Post by DennisP »

throwaway290 wrote: post #96
DennisP wrote: post #95

Earlier quoted context omitted.

Which is why you only test in situations where, if the test is positive, you have better odds if you treat.

Better odds to live longer or have good life? Looks like this study says it's definitely not the former?

Untreated cancer is not without its effects on quality of life.

As I said above, with a positive test, work out the numbers for death and other unpleasant outcomes, with or without treatment, and let the patient decide. If those numbers would say not to treat regardless of test results, then don't test.

The study just says that most, not all, cancer screenings don't extend life. And it doesn't say whether doctors are giving patients the numbers I described. I suspect they aren't, which likely means that sometimes they treat even when these numbers would say they shouldn't.

Re: Most cancer screenings don’t extend life, study finds

#104

Post by giarc »

Flatcircle wrote: post #98

Breast cancer screens def save lives. Can't speak to all screenings but some def work.

"mammography screening did not prolong life" from the abstract.

If you are unfortunately talking about a personal experience, sorry, but you can't confuse n=1 stories with large research studies.

Re: Most cancer screenings don’t extend life, study finds

#105

Post by teuobk »

Flatcircle wrote: post #98

Breast cancer screens def save lives. Can't speak to all screenings but some def work.

Except breast cancer screening, at least via mammography, doesn't save lives. See, for example: https://thennt.com/nnt/screening-mammography-for-reducing-de...

Re: Most cancer screenings don’t extend life, study finds

#106

Post by psychphysic »

This is not an unexpected result. Last I checked breast self examination also does not reduce deaths from breast cancer, nor testicular self examination.

If anyone's interested the "Wilson criteria" is the basis of decisions about screening programmes and many run programmes fail it.

Re: Most cancer screenings don’t extend life, study finds

#108

Post by jbandela1 »

What surprising to me is that sigmoidoscopy shows a benefit but colonoscopy doesn’t.

In colonoscopy, the entire colon is examined by using a long flexible tube. In sigmoidoscopy, only the lower portion of the colon is checked, again by using a flexible tube.

The things that come to mind is that sigmoidoscopy may be better tolerated by patients or have fewer complications.

Re: Most cancer screenings don’t extend life, study finds

#109

Post by giarc »

jbandela1 wrote: post #108

What surprising to me is that sigmoidoscopy shows a benefit but colonoscopy doesn’t. In colonoscopy, the entire colon is examined by using a long flexible tube. In sigmoidoscopy, only the lower portion of the colon is checked, again by using a flexible tube. The things that come to mind is that sigmoidoscopy may be better tolerated by patients or have fewer complications.

Likely that the cancers found by the sigmoid are the ones that reduce life years. Perhaps the cancers that are found and treated higher up the colon would have been found out in other ways or not serious enough? I'm not a doctor, so not sure.
Post reply on HN