Earlier quoted context omitted.
MD here. It's "not done" because it could hurt you. Here's the Bayesian argument: - Let's assume a lab test (or imaging test) has a 1% false positive rate and 100% sensitivity (that would be pretty good for many tests and imaging modalities!). - The cancer you screening for has a 1% incidence as well (low-ish, for the sake of argument). - Therefore the chance that a "positive" scan would be due to a false positive or…
Maybe figure out a better way to verify that doesn't require biopsy? Maybe use machine learning in conjunction with better data? I don't know enough but there must be other techniques we could devise that don't require major invasive surgery every single time. Just sitting on our hands on this information and letting people die is the worst decision. We need to improve our technology to get better results, not throw…
If the alternative is saving a few who would otherwise die, but taking away more healthy days from many others or, possibly, even killing healthy individuals because they get overtreated, not spending money on screening _now_, but instead spending money on better understanding is the rational thing to do.
And that’s exactly what we are doing. Technology advances, models get refined. Maybe, some day, statistics (and ethics committees) will decide population screening does make sense.
And it isn’t necessarily about major invasive surgery. Even small procedures, done unnecessarily often enough, may already swing the balance.
Also, in some cases knowing that you have cancer may not affect your life expectancy at all. https://en.wikipedia.org/wiki/Screening_(medicine)#Overdiagn...:
”Screening may identify abnormalities that would never cause a problem in a person's lifetime. An example of this is prostate cancer screening; it has been said that "more men die with prostate cancer than of it". Autopsy studies have shown that between 14 and 77% of elderly men who have died of other causes are found to have had prostate cancer.[
Aside from issues with unnecessary treatment (prostate cancer treatment is by no means without risk), overdiagnosis makes a study look good at picking up abnormalities, even though they are sometimes harmless.
Overdiagnosis occurs when all of these people with harmless abnormalities are counted as "lives saved" by the screening, rather than as "healthy people needlessly harmed by overdiagnosis". So it might lead to a endless cycle: the greater the overdiagnosis, the more people will think screening is more effective than it is, which can reinforce people to do more screening tests, leading to even more overdiagnosis.”