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How often do full-body MRIs find cancer?

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Re: How often do full-body MRIs find cancer?

#71

Post by AYBABTME »

tsoukase wrote: post #70

There are two points in MRIs that limit or (better) regulate their use: * financial cost vs level of care. A full body MRI costs a huge sum but it is the most detailed non-invasive diagnosis we have for any disease that can lead to earlier therapy. Used as a screening method, does it worth to save one patient in tens/hundreds tests performed? You answer, but public health authorities, health insurances and medical so…

For some reason, I always found the arguments for "it's better to not know" for these tests to be strange and slightly infantilizing. But of course this must not be the end of it, and there might be some more well thought out arguments from bioethicists that go beyond "the patient can't handle the truth". Because this argument seems like it's doing a lot of heavy lifting without much evidence.

Re: How often do full-body MRIs find cancer?

#72

Post by [deleted] »

AYBABTME wrote: post #71
tsoukase wrote: post #70

There are two points in MRIs that limit or (better) regulate their use: * financial cost vs level of care. A full body MRI costs a huge sum but it is the most detailed non-invasive diagnosis we have for any disease that can lead to earlier therapy. Used as a screening method, does it worth to save one patient in tens/hundreds tests performed? You answer, but public health authorities, health insurances and medical so…

For some reason, I always found the arguments for "it's better to not know" for these tests to be strange and slightly infantilizing. But of course this must not be the end of it, and there might be some more well thought out arguments from bioethicists that go beyond "the patient can't handle the truth". Because this argument seems like it's doing a lot of heavy lifting without much evidence.

[deleted]

Re: How often do full-body MRIs find cancer?

#73

Post by lostlogin »

mcbain wrote: post #24
p0pularopinion wrote: post #17

Earlier quoted context omitted.

> My father is a part of "full body PET scan every 3 years" program as part of post - cancer treatment, These treatments are wonderful and it is great that they exist. But many people fail to understand the difference in terms of pretest probability, etc. I can absolutely see the heavy psychological impact pending biopsy results may have. People are quick to discount these issues when you raise them as a concern, but…

I have multiple scans a year. "Scanxiety" is real.

Multiple PETs?

Re: How often do full-body MRIs find cancer?

#74

Post by lostlogin »

mgraczyk wrote: post #25
mmaunder wrote: post #13

“ One study in 2020 found that 95% of asymptomatic patients had some type of "abnormal" finding, but just 1.8% of these findings were indeed cancer.” This has been my experience. And I’ve had oncologists echo exactly this. In the words of one: MRIs find too much. The CT and the PET/CT are the gold standards for finding cancer, finding recurrences, and staging cancer. The trouble is the radiation dose. MRI provides ve…

And yes getting frequent full body MRIs is still overwhelming the right thing for the patient.

Here in NZ an Australia, the college of radiologists disagree and say ‘don’t do it’ for screening the worried well.

https://www.ranzcr.com/college/document-library/2024-positio...

Re: How often do full-body MRIs find cancer?

#75

Post by [deleted] »

mgraczyk wrote: post #29

Doctors here are cognitively captured by a system designed to limit cost (and that's mostly a good thing) But scanning frequently is overwhelmingly good for the patient. The problem is the doctors. Imagine two possibilities. 1. You scan every six months and a doctor reviews your scans but never tells you anything no matter what 2. You scan every six months and a doctor reviews your scans and only tells you results if…

[deleted]

Re: How often do full-body MRIs find cancer?

#76

Post by lostlogin »

giantg2 wrote: post #20

Just to point out, cancer isn't the only reason to get these. Aneurisms, hemachromatosis, etc can all be serious. I know someone who got scanned for $500 and they caught hemachromatosis via iron deposits in the liver. Much better than eventual chirrosis and liver failure.

A blood test is a far cheaper way to check this.

Re: How often do full-body MRIs find cancer?

#77

Post by lostlogin »

tptacek wrote: post #31
cyberax wrote: post #22

Earlier quoted context omitted.

"Worth watching" implies that watching is expensive. It's really not. A full-body MRI scan is about $1k, and it can be even cheaper. So if you have abnormal findings in 10% of patients that merit follow-up scans, you can trivially do a series of 3-4 scans without affecting the overall cost too much. Doctors simply need to get out of the headspace where MRIs are extremely scarce tools of last resort and treat them lik…

I think you're missing the point. The psychological cost of a conditional-positive result is nonzero, and can be very significant (I speak from a little bit of experience here). But far more importantly: the physiological cost of invasive followups when you eventually trip the threshold of "time to go explore with a scalpel" is very high, and the missing evidence this story is about is whether you can get to that thr…

This is pretty much what the experts say:

https://www.ranzcr.com/college/document-library/2024-positio...

Re: How often do full-body MRIs find cancer?

#78

Post by cheschire »

AYBABTME wrote: post #71
tsoukase wrote: post #70

There are two points in MRIs that limit or (better) regulate their use: * financial cost vs level of care. A full body MRI costs a huge sum but it is the most detailed non-invasive diagnosis we have for any disease that can lead to earlier therapy. Used as a screening method, does it worth to save one patient in tens/hundreds tests performed? You answer, but public health authorities, health insurances and medical so…

For some reason, I always found the arguments for "it's better to not know" for these tests to be strange and slightly infantilizing. But of course this must not be the end of it, and there might be some more well thought out arguments from bioethicists that go beyond "the patient can't handle the truth". Because this argument seems like it's doing a lot of heavy lifting without much evidence.

“slightly infantilizing” might be an appropriate course given how well LLM sycophancy works on the general populace.

Re: How often do full-body MRIs find cancer?

#79

Post by mgraczyk »

lostlogin wrote: post #74
mgraczyk wrote: post #25

Earlier quoted context omitted.

And yes getting frequent full body MRIs is still overwhelming the right thing for the patient.

Here in NZ an Australia, the college of radiologists disagree and say ‘don’t do it’ for screening the worried well. https://www.ranzcr.com/college/document-library/2024-positio...

Seems like their main concern is "substantial downstream healthcare costs"

Re: How often do full-body MRIs find cancer?

#80

Post by lostlogin »

mgraczyk wrote: post #79
lostlogin wrote: post #74

Earlier quoted context omitted.

Here in NZ an Australia, the college of radiologists disagree and say ‘don’t do it’ for screening the worried well. https://www.ranzcr.com/college/document-library/2024-positio...

Seems like their main concern is "substantial downstream healthcare costs"

Yes, and needless biopsy can be a big deal.

It’s a great document, I’m an MR tech and we now have something to lean on when we say no to these scans. We can then scan people with problems rather than people with too much money.

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