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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

#91

Post by somenameforme »

HWR_14 wrote: post #72
francisofascii wrote: post #27

Earlier quoted context omitted.

> except for colorectal screenings where the difference was about 4 months of difference That sounds, uh, significant. So to clarify, does that mean people gain 4 months on average by getting this screening? Those who get the cancer gain years, and those that don't gain 0, so the average is 4 months?

That is how I read it. It also makes me wonder that if some cancers are rare enough to average to 0 months (rounded down) that could still work out to a 1/500 chance of living to 80 vs 40. Long odds it matters, but big difference if it does.

They were testing for some of the most frequent cancers (breast, colorectal, lung cancer (in smokers), prostate), and measuring differences in outcomes down to the day.

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

#92

Post by paddim8 »

porcoda wrote: post #47

(Note: very US centric comment here) I’ve become skeptical of the motives behind any article that seems to seed some level of doubt about health screenings and any preventative or treatment measure that involves the healthcare system itself. They always stink of the insurance and for-profit healthcare system and their aversion to paying anything out beyond the absolute bare minimum to get people the care they need. I…

In Europe, screenings generally aren't a thing unless you're in some risk group. It's not deemed to be effective enough and staff already have a bunch of actually sick people to treat

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

#93

Post by [deleted] »

somenameforme wrote: post #91
HWR_14 wrote: post #72

Earlier quoted context omitted.

That is how I read it. It also makes me wonder that if some cancers are rare enough to average to 0 months (rounded down) that could still work out to a 1/500 chance of living to 80 vs 40. Long odds it matters, but big difference if it does.

They were testing for some of the most frequent cancers (breast, colorectal, lung cancer (in smokers), prostate), and measuring differences in outcomes down to the day.

[deleted]

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

#94

Post by throwaway290 »

DennisP wrote: post #87
idopmstuff wrote: post #80

Earlier quoted context omitted.

> Tell the patient the risk of each outcome. This isn't a simple problem of calculating EV. Telling somebody that there's a 40% chance that the positive test is actually wrong and in the 60% case that it's right, 40% of the time it's going to be benign, but if it's not benign it might kill them but if it is benign and they do surgery they might be left wearing diapers is not a simple thing for a person to evaluate. A…

No, I mean you take the test and if it's positive then present options like this: Risk of death: X% with treatment, Y% without treatment. Risk of side effect A: X% with treatment, Y% without treatment. Those numbers take into account the rate of false positives and false negatives. They are clear and understandable. There are definitely situations in which you shouldn't test: where the rate of the cancer is low, the…

Simply having the information that they maybe have cancer, people are not great at just living unstressed because it may or may not be a false positive. And stress is known to cause a lot of problems including weakening immune system.

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

#95

Post by DennisP »

throwaway290 wrote: post #94
DennisP wrote: post #87

Earlier quoted context omitted.

No, I mean you take the test and if it's positive then present options like this: Risk of death: X% with treatment, Y% without treatment. Risk of side effect A: X% with treatment, Y% without treatment. Those numbers take into account the rate of false positives and false negatives. They are clear and understandable. There are definitely situations in which you shouldn't test: where the rate of the cancer is low, the…

Simply having the information that they maybe have cancer, people are not great at just living unstressed because it may or may not be a false positive. And stress is known to cause a lot of problems including weakening immune system.

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

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

#96

Post by throwaway290 »

DennisP wrote: post #95
throwaway290 wrote: post #94

Earlier quoted context omitted.

Simply having the information that they maybe have cancer, people are not great at just living unstressed because it may or may not be a false positive. And stress is known to cause a lot of problems including weakening immune system.

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?

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

#97

Post by LorenPechtel »

kazinator wrote: post #73
LorenPechtel wrote: post #65

Earlier quoted context omitted.

No, because we might be replacing one cause with another. That's what they've found with PSA--it kills (via treating things that wouldn't actually have killed the patient) as many as it saves.

> That's what they've found with PSA--it kills (via treating things ...) I'm not sure what PSA you're referring to. The Prostate-Specific Antigen PSA is something secreted by the body, and not a treatment, so it can't be that one. Are you referring to overdiagnosis (via PSA or any other screening), resulting in overtreatment?

PSA is also commonly used to refer to the test that measures the PSA level.

And, yes, it's treatment of things that weren't actually going to kill the patient. It's been known for quite a while that doing the test for screening produces no increase in life expectancy.

What this study is saying is that the same problem seems to apply to most other cancer screenings.

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

#99

Post by kwhitefoot »

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.
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