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Blood test that finds 50 types of cancer is accurate enough to be rolled out

theguardian.com

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Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#351

Post by jacquesm »

vmception wrote: post #329
dryrun wrote: post #36

Earlier quoted context omitted.

Given the amount of "I don't want bill gates injecting me a tracker!", I have some idea of how a conversation with the same people about nano machines in their body would go. I would also bet on the time-frame between this and the availability of your data on the servers of your health insurance.

Not my problem, human cancers stay in there own bodies and are not communicable To our knowledge

Not normally, no. But there are some puzzling exceptions:

https://www.discovermagazine.com/health/the-cancers-that-are...

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#352

Post by vmception »

jacquesm wrote: post #351
vmception wrote: post #329

Earlier quoted context omitted.

Not my problem, human cancers stay in there own bodies and are not communicable To our knowledge

Not normally, no. But there are some puzzling exceptions: https://www.discovermagazine.com/health/the-cancers-that-are...

These are all in animals and I specified human cancers for that specific reason, thanks for the article though, I only knew about the Tasmanian Devil one

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#353

Post by sjg007 »

vidarh wrote: post #330
fallingknife wrote: post #186

Earlier quoted context omitted.

> but doctors can't always predict this and aren't perfect decision making machines So mass screen healthy people, collect the data, run models, and get better at it. People like you would rather not try, and this is the same reaction I get from doctors. Applying the same tech that we use to improve ad targeting to disease prediction is a no brainer to anyone whose cushy job doesn't depend on the current medieval sta…

We have done this for e.g. breast cancer, and that is exactly why people are cautious now, because we have real data on the harm overtesting can cause. That doesn't mean it should never be done, but that it needs to be approached with care.

Prostate cancer as well.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#354

Post by jacquesm »

vmception wrote: post #352
jacquesm wrote: post #351

Earlier quoted context omitted.

Not normally, no. But there are some puzzling exceptions: https://www.discovermagazine.com/health/the-cancers-that-are...

These are all in animals and I specified human cancers for that specific reason, thanks for the article though, I only knew about the Tasmanian Devil one

Yes, correct. But there are also some viruses that cause cancer that can spread from human to human (HPV for instance, the cause of cervical cancer), and the case of that doctor is some proof that at least in theory cancer can spread by blood or tissue contact.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#355

Post by timy2shoes »

scarecrowboat wrote: post #331
moralestapia wrote: post #293

Earlier quoted context omitted.

I feel it's a net win anyway, if the procedure is not invasive and cheap, you could take one every so often (yearly?) and if something shows up you just double check with a better method or w/e. Better than nothing, which is the current alternative.

What if the followup procedure is invasive and expensive? It's possible that this procedure could be net negative in aggregate depending on the % of false positives and # of resulting needless followup procedures. Not to mention the emotional stress.

Exactly! This reminds of the recent case of the AMA increasing the suggested age of regular mammograms. More testing means earlier detection of breast cancer. But a false positive means an invasive biopsy. These are the two sides that need to be balanced. The AMA decided that since the base rate of cancer is so low in women under 50, the posterior probability that you have cancer given a positive mammogram for the under 50 age group is considerably low. Therefore they decided that the increased costs (monetary and emotional) do not outweigh the benefits.

From https://www.ama-assn.org/sites/ama-assn.org/files/corp/media...

"Screening mammography reduces mortality from breast cancer, including in women younger than age 50 years. However, screening mammography carries harms such as false positive results that can lead to additional imaging and invasive biopsy procedures, and overdiagnosis that could lead to treatment in patients who may not benefit from it. The USPSTF considered the balance of benefits and harms using a commissioned targeted systematic evidence review of randomized clinical trials and a decision analysis that compared the expected health outcomes of starting and ending mammography at different ages and using annual and biennial screening strategies; it concluded (in part) that routine screening should begin at age 50 years and continue biennially until age 74 years."

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#356

Post by wxnx »

epicureanideal wrote: post #308
rackjack wrote: post #190

Earlier quoted context omitted.

Same vibe as "I would just simply..." What do you think the entire medical, pharmaceutical, bioinformatic, etc. industries have been doing for decades? Are you really so arrogant to think that other people are too lazy and stupid to think of your brilliant idea and that you are simply more intelligent than everybody else? Do you really think people haven't been trying?

> What do you think the entire medical, pharmaceutical, bioinformatic, etc. industries have been doing for decades? Well, let's remember that the AlphaFold team at Google solved the protein folding problem with a relatively small team in a relatively small number of years after extremely large, well funded companies whose primary business was drug development failed to do so for decades. So yeah, it's been demonstrat…

There's confounding here that you're ignoring. For reference, I'm a machine learning research scientist who started in bioinformatics, initially lured by the possibility of a machine learning solution to the protein folding problem.

Google's research arm has made leaps and bounds in a particular field (deep learning) and then managed to apply it successfully to a very, very hard problem (protein folding). That other companies failed to adapt Google's successes in deep learning faster than Google is not surprising at all to me.

One might argue that the impact of academic-big pharma collaboration (in the form of funding for research projects related to CASP) is what enabled a company like Google, with no independent desire to collect the massive amounts of wetlab data required to evaluate or develop a tool like AlphaFold, to even participate.

More importantly, AlphaFold hasn't really solved the protein folding problem well enough for drug development. So, the entire debate might be moot.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#357

Post by colinmhayes »

plank_time wrote: post #137
jacquesm wrote: post #132

Earlier quoted context omitted.

Even if you detect cancer you will still need a biopsy to figure out which bits are the cancer and which bits are just 'lumps'. Yes, it is a game changer, but it is not the kind of game changer that this is being made out to be here and mass screening using this method is not going to lead to improved outcomes. As an extra tool in the toolbox of the diagnostician it is very useful.

It’s pretty easy. If blood test says “liver cancer positive. Colon cancer negative.” you check the liver for cancer. No need to check the colon for cancer. No need to scan the entire body for lumps.

What happens when it turns out that most of the people having surgery don't have cancer? Because that's the reality of tests with a .5% false positive rate if less than 1% of the population is positive.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#359

Post by jjeaff »

deeviant wrote: post #272
rackjack wrote: post #190

Earlier quoted context omitted.

Same vibe as "I would just simply..." What do you think the entire medical, pharmaceutical, bioinformatic, etc. industries have been doing for decades? Are you really so arrogant to think that other people are too lazy and stupid to think of your brilliant idea and that you are simply more intelligent than everybody else? Do you really think people haven't been trying?

> Are you really so arrogant to think that other people are too lazy and stupid to think of your brilliant idea and that you are simply more intelligent than everybody else? Do you really think people haven't been trying? I find it hard to believe I'm reading this sentiment on HN. Do you realize nearly any disruptive idea has do the "arrogant" thing you are speaking off. Big companies go out of business all the time,…

I didn't understand their comment to mean that at all. It's not arrogant to think there might be a better way. It probably is arrogant to think that the better way is actually really simple and easy to implement.

Arrogance definitely can play a big role in success of many startup entrepreneurs. Because they think the answer is simple and their arrogance shields them from not trying. So they go down the road and find out the solution is actually quite complicated, but a small percentage succeed in accomplishing the goal.

But it's still arrogance, nonetheless.

Re: Blood test that finds 50 types of cancer is accurate enough to be rolled out

#360

Post by theptip »

colinmhayes wrote: post #321
moralestapia wrote: post #293

Earlier quoted context omitted.

I feel it's a net win anyway, if the procedure is not invasive and cheap, you could take one every so often (yearly?) and if something shows up you just double check with a better method or w/e. Better than nothing, which is the current alternative.

The problem is people are idiots. They get a false positive and their doctors tells them "well there are a lot of false positives with this test" but all people hear is "you have cancer." Then they get an invasive biopsy because the healthcare system is glad to take your money.

I appreciate you stating it frankly, I think a lot of people in this thread are arguing a variation of this point without saying it aloud.

A couple thoughts -

1) If this is the only/main objection, then the test is good news for those that are analytically capable, even if it's potentially bad for Joe Median.

2) While what you describe is how it probably happens in general in the USA, but I wonder if it plays out differently in, say, the UK / Canada under NHS/Medicare. In those systems you don't get to pick your treatments; your doctor will only prescribe a follow-up if it meets ROI standards. (Then the health system picks up the bill). Of course you can go private but there's a pretty big barrier there, and perhaps having your GP push back more strongly (as they would if you were not actually at high risk) that might prevent many people from inferring too much from a potentially-false positive result.

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