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Most cancer screenings don’t extend life, study finds

cnn.com

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

#111

Post by michael1999 »

discussed here - https://news.ycombinator.com/item?id=37296122

I found this comment useful: - https://news.ycombinator.com/item?id=37297963

Several comments noted that a 4 month improvement in life expectancy (for sigmoidoscopy) over the whole population is actually pretty good for a low-incidence cancer. That's several years for the people who actually get it.

But the comments seem naive about the downsides of broad screening: over-treatment, iatrogenic disease, false positives, opportunity cost, etc.

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

#112

Post by haldujai »

kwhitefoot wrote: post #99

The patient is not interested in the effect on the average life expectancy of all people in society, they are only interested in their own case when they are diagnosed early enough to have treatment that will extend their life if they have cancer. This is a different sub-population.

That's not the criteria for population level interventions. This is to answer the question of whether should the USPSTF make a positive recommendation and force insurers to pay or if public health systems should adopt this.

You're conflating this with individual patient decisions.

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

#113

Post by 0cf8612b2e1e »

> In this systematic review and meta-analysis of 18 long-term randomized clinical trials involving 2.1 million individuals, colorectal cancer screening with sigmoidoscopy prolonged lifetime by 110 days, while fecal testing and mammography screening did not prolong life…

That is shockingly bad. An extra three months of life is not nothing, but not exactly a clear win to push people towards the added stress and effort to be screened.

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

#114

Post by op00to »

0cf8612b2e1e wrote: post #113

> In this systematic review and meta-analysis of 18 long-term randomized clinical trials involving 2.1 million individuals, colorectal cancer screening with sigmoidoscopy prolonged lifetime by 110 days, while fecal testing and mammography screening did not prolong life… That is shockingly bad. An extra three months of life is not nothing, but not exactly a clear win to push people towards the added stress and effort…

What about quality of life? Colon cancer did not kill my wife's Grandma, but complications of the surgery did.

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

#115

Post by bironran »

teuobk wrote: post #105
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...

oh wow.

"This is an important, though uncommonly discussed, issue in the translation of evidence from cancer screening trials.1 It is known that overdiagnosis (treatment of cancers that would have been no threat), and high false positive rates (misdiagnosis) lead to medical harms and unnecessary surgeries, chemotherapy, and radiation...

...margin of benefit suggested by the analysis above it seems likely that if there is a benefit to screening mammography it is balanced out by mortal harms from overdiagnosis and false-positives"

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

#116

Post by hvs »

Flatcircle wrote: post #98

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

Cancer treatment isn't a complete positive. If you subject large numbers of people to it some of them will die from the treatment. If you save 1 person from cancer but kill 5 more that didn't have it, is that a net positive?

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

#117

Post by trgn »

stevehawk wrote: post #107

Is this study just proving that other things kill you while you're being or after you've been treated for cancer?

It provides evidence that a diagnostic approach to healthcare misunderstands that good health is a complex expression of a million factors, and not a function of the number of healthcare interventions.

A diagnostic approach to healthcare can be easily bureaucratized (come collect your stamp after your colonoscopy!). A touchy-feely "million factors" approach cannot.

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

#118

Post by op00to »

teuobk wrote: post #105
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...

I worked in a lab doing cancer detection via image AI (mammograms, mri, etc) back in 2008 or so, and even then we knew that mammography didn't save lives.

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

#119

Post by freedude »

My wife's grandpa was diagnosed with prostate cancer. He was 82 and had been a natural food store owner for over 30 years. He said the side effects to the treatment and the surgery was too great for him to endure and would impede his quality of life. He passed away 4 years later from pneumonia unrelated to the cancer. The cancer wasn't easy to deal with in those four years. He wasn't cut up and on chemo or radiation either. I agree with him in that too much can be "done"

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

#120

Post by dang »

michael1999 wrote: post #111

discussed here - https://news.ycombinator.com/item?id=37296122 I found this comment useful: - https://news.ycombinator.com/item?id=37297963 Several comments noted that a 4 month improvement in life expectancy (for sigmoidoscopy) over the whole population is actually pretty good for a low-incidence cancer. That's several years for the people who actually get it. But the comments seem naive about the downsides of broad…

(this comment was originally posted to https://news.ycombinator.com/item?id=37312540, but we've merged that thread hither. that's why the comment links to its own thread now)
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