"Some cancer specialists counter these concerns, saying the surge in diagnoses is primarily a surge in detecting cancers that did not need to be found..."
This seems excessively paternalistic. If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things, it leaves patients with no way to discover life-altering information about their own health.
If the cancer is not clinically significant, then its not life-altering information.
Essentially they are saying that many of these diagnoses are potentially false positives. To the point where detecting them might be more harmful then not. Keep in mind most cancer treatments are pretty harsh. They are better than cancer, but if you don't have clinically significant cancer then the treatments can be very not worth it.
disclosing information is not a medically neutral act. Knowing you have a medical condition can create a great deal of anxiety and anguish and prompt lots of tests. If the result of all those tests and anxiety is "no action indicated," you've basically given your patient a condition that reduces their quality of life for no upside.
I once had a misdiagnosis of an incurable illness that I didn't actually have, and the stress of dealing with that caused me to develop another, very real medical condition that took a year to get under control.
Hypothetically (totally made up numbers), if a positive result on the test means there is 1/10000 chance you have cancer, and negative result means a 1/20000 chance, with the test also having a 1/1000 chance of giving the patient an adverse reaction, i think the questions most patients would ask is why was the test run in the first place?
We're not talking about hiding information, we're talking about not looking for it in the first place. Information that is costly to acquire but not actionable once acquired.
in some cases the knowledge itself is a curse. These commenters mostly have no clue what they’re talking about and it shows.
My spouse found out they had a benign brain tumor, an accidental discovery while doing a brain scan for some other reason. She now has to get annual scans done to make sure the size doesn’t change. Guess what? It hasn’t changed in 5 years.
You might say “better safe than sorry!” To that i say - bullshit. It’s caused her lots of unnecessary stress and anxiety. EVERY year she goes back to the testing center and stresses out about if it’s changed in the last year. She sleeps poorly sometimes because of the anxiety, etc. Knowing every microscopic issue within your body is not always a net benefit! Quality of life matters too, not just longevity.
I think it really depends on the type of cancer. Actionable information is the most useful information.
So my wife has gone through all this extra stress to MAYBE catch a cancerous tumor (28%). That’s assuming it grows large enough to impact her before she dies naturally. And I see that the survival rate of some brain tumors, even if found very early, is very poor (5-10% for some tumors, like glioblastoma).
Lots of “what if’s” here. And for what? All i’m arguing is, knowledge is not always actionable, and what’s not actionable can keep you up at night.
The point i’m making is, we should not be trying to pursue a life of 0 risk and perfect decisions. Life is filled with risk (and good and bad luck). That’s just life.
It depends on your personality or worldview. Some people would be much more comfortable lowering their chances of “what ifs” than leaving it all to fate.
i agree with you. If a patient expresses that sentiment to their doctor, they should act accordingly and order the extra screening. At the end of the day it should be a conversation with your provider.
There should definitely be an honest discussion about pros and cons. And not just the physical, but the mental aspect as well.
On the other hand, the placebo effect works even when the placebo is clearly labelled "placebo". So I guess there's potential to tell people needlessly disconcerting facts and then take the edge off with reassuring bluster and functionless comforts.
This is a "why don't you just" answer. The reason the establishment does this is that we know the outcome of telling people is worse than not telling them. This is an expensive lesson learned over over a century of medical treatment.
Yes, because I have met many doctors whose judgement I profoundly mistrust, and prefer my own. Sometimes their whole paradigm is flawed, but sometimes they're just not informed about my own values. And I would rather die by my own misjudgment than theirs.
I'm an old guy, it's happened several times. The last time, a surgeon removed a tumor, found that it was malignant ... and then told me that it was no big deal, it was a kind of cancer that would not have caused serious problems. She said if she had to get cancer she'd pick this kind. I wish she had told me that before the surgery. I may have had it anyway, but maybe not. Wouldn't you value being fully informed more after that? Surgeons have as much of a conflict of interest when selling their own services as anyone else.
I'm not sure what your point is. This discussion is about medical researchers making decisions on thousands or millions of patients in aggregate... what you're describing is a common thing (don't know how bad a tumor is until it's removed).
The doctor didn't know that before removing the tumor (almost certainly; the alternative is medical fraud).
Doctors going into uber salesman mode selling dangerous surgery is super common. So very common among heart surgeons it’s comical. Point is, blindly trusting doctors and their judgements will in all likelihood just turn you into a sickly perma patient.
Also, if the outcome is worse by informing, doesn't that imply a violation of "first, do no harm"? Which, to be fair, the OP says they wouldn't prioritize...
Depends on how you interpret: "First do no harm". Is that an obligation to minimize the harm to an individual patient? Or is the goal to maximize the health of many patients? Like I've said elsewhere, medical reasoning is subtle.
We don't know if a tumor is harmless, but we do know that treatment has significant harm. Radiation and chemotherapy are nasty. We also know that the stress of a positive diagnosis has significant harm.
I agree. I wouldn't contest "cancers that did not need to be treated", but this would imply finding, following, and deciding if the tumor needs treatment.
Not needing to be found sounds like cost saving, leave that to the accountants.
There is cancer in your body every single day. Your immune system handles it just fine. There is an explicit difference between cancer that needs treating and cancer that should be ignored because it's a waste of time and resources to treat. You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason.
We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.
My father has a high rate PSA change a few years ago so I learned everything I could about prostate cancer for about 4 weeks.
I then talked to several doctors I know (family practice and two internal medicine).
It was embarrassing how little they knew. And even more shocking actually, is how wrong they were about things.
Two of them told me the risk of infection from a prostate biopsy was basically zero. I asked for clarification with actual numbers, and even led them with "for what kind? Like 1 in 100 or 1 in 1000?"
One said basically zero, the other said 1 in a million.
Neither knew to mention the two common types, and to make sure we go with the one type that carries less risk of infection.
Even then, the less risky one is about 1 in 1000. If you have bad insurance you might go with the older type which is about 1 in 100. And that's with them giving you antibiotics beforehand....
Basically they got everything I asked about wrong compared to specialists you can read online.
Ps, my dad got an MRI with two 1cm growths.
He changed his diet and added fasts, and did nothing else. His doctor basically writing him off in anger.
5 years later, PSA lower than before the incident. Paid for a scan last year, zero growth.
Internet/YouTube experts/doctors really do beat most general doctors. The odds of you having someone in the top 10% of their field, let alone top 1-2% in your local town is pretty low. Even my bay area doctor friends work at pretty basic general bay area hospitals. Imagine who's left in Modesto, CA.
I'm glad your dad got better, it had nothing to do with his diet and fasting. It's no different than Steve Jobs stubbornly becoming a fruititarian to treat his cancer. If his immune system had fought it off, then fruit would be a cancer cure and all his doctors would be idiots.
Youtube/Internet experts are one of the largest propagators of medical misinformation and are actively harming people every day, and if I've ever been in favor of restricting free speech, it's giving out medical advice without a license. If we can restrict giving legal advice, and everyone understands how painfully stupid you'd have to be to represent yourself in court without a law degree, then we can restrict giving medical advice, and hopefully people can realize how painfully stupid you'd have to be to manage your own medical treatments without a medical degree.
Regarding Steve Jobs, that's unfortunate for him because even my grandmother in Poland used to say "sugar causes/feeds cancer" when she tried to get us to stop sweetening our tea back in the 80s before we left.
Somehow she knew what several doctors and researchers are now documenting, that cancer cells have a much harder time growing without ample amounts of glucose.
Oh great, another expert. Except without the 30 years of research and experience.
One guy wins the nobel prize for detailing a function of fasting and its effects on the immune system and cell repair/death... But fasting doesn't help! We know this, because a guy on hacker news said so.
Your response is a non-sequitur. The original statement was about intentionally not detecting cancer. You are talking about whether the cancer is medically necessary to treat.
You are just assuming that all cancer must be treated if detected, even if it is medically unnecessary, therefore we must not detect medically insignificant cancer which would be net harmful to treat. You can detect things and determine no action should be taken. I can understand if that might be the modern standard of care, but if so then that is the problem; not early detection of cancer, which could be medically insignificant, but which may also allow the early detection of medically significant cancer.
I'm pretty sure every medical show had an episode where the "money-grubbing hospital admin" character want to start selling full body medical scans, and the "very well-respected and honor-bound doctor" character points out how this is quite literally one of the most useless and corrupt ways for a hospital to make money.
There are probably a dozen things wrong with your body right now. That doesn't mean they're even affecting you. While you may have some type of cancer that is at the absolute first day of detectability, or a bone slightly out of place, or a weird spot on your heart, someone else has a case that is 6 months deeper and needs more dire treatment.
There is zero benefit to society to massively overburden our healthcare system (this is true of any nation) by searching constantly for random problems that may or may not exist.
If there were good reason to do this, you'd have regularly-scheduled checkups, like with colon or breast cancer.
at the same time you have endless stories of people losing family and friends to cancer because a doctor dismissed complaints as anxiety or needing to exercise more leading to cancer not being discovered until it was too late to treat.
The answer can't be to put our collective heads in the sand.
Perhaps BOTH the "money-grubbing hospital admin" and the "very well-respected and honor-bound doctor" are wrong for not involving their patients in these decision? And their insurance for that matter.
Recently my US-system, world-ranking university hospital complex was first convinced that my insurance would not pay for XXX (and consequently did not recommend it and delayed it). Then after I insisted and got that done, they told me how surprised they were (1) that my (US) insurance did in fact cover every single bit of everything we eventually got done and (2) how MUCH that same US insurance in fact paid them for each of the bits. On the first try. That insurance company has horrible problems, but I can't complain that they didn't cover the hell out of the thing. You know - on the same year we read everyone else's horror stories.
You also have the issue of information creating liability. A thing that nobody knows about is nobody's problem, a thing that COULD be a problem but probably isn't in someone's professional judgement creates liability for the decision maker.
It's a human factors thing. If two patients both have a cancerous tumor that does not need treatment, the patient that did not have a screening is better off. The patient who was screened will deal with anxiety from having a positive screening result in addition to any negative effects from the screening and follow ups. Many patients are not comfortable living with a detected tumor, even if the standard of care is to watch and wait. Of course, the opposite scenario is also true --- if both patients have a tumor were removal would be best, the one that gets screened has a better outcome.
Maybe if we were all pretty rational people, we could better manage positive screening results and follow up actions that lead towards taking no specific action; but that's not where people are at the moment.
There's a tradeoff of early detection of fast growing tumors that are likely to cause issues vs detection of slow growing tumors that are likely to not cause issues except if they're detected. You can see how the consensus is shifting on things like breast, prostate, and colon cancer screenings over time. My TLDR is that we developed tools and methods, started applying them and have generally reduced the screening frequency over time as we understand more about the tradeoffs.
Except that the medical system already does that for various types of common cancer screening such as breast cancer. It is frequently detected extremely early when it is medically insignificant and patients may be recommended to just wait and watch with more frequent screening. Increased vigilance would have been impossible without early detection and early detection for breast cancer is viewed very positively and is very positive for society.
We have a system that partially results in anxiety because cancer screening is frequently only done when cancer would already be medically significant. A positive result usually means medically significant cancer because as a society we already chose to not screen when it would be medically insignificant. This is perfectly reasonable if the test is expensive, inaccurate, or harmful as even just the harms from doing the test in bulk could result in societally worse outcomes than occasional early detection. However, the rise in "medically unnecessary" screening indicates that we have turned the corner on that in many cases; that or it is easily billed corruption which is a separate problem.
What determines if a cancer should be treated is the type, size, growth, and age of a patient.
Type and size and growth you can't find out without doing some sort of test/screening.
I agree that oncologists are ultimately who should be making the call on what needs to be treated and how. But I think your characterization of how common non-dangerous tumors are is off.
> We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.
Strawman. No one is suggesting adding extra stress to healthcare workers. It's also not you or your doctors call to make: let's gatekeep this patients cancer because our hospital can't deal with the workload. What a truly wicked idea.
To help alleviate the extreme shortage of available healthcare workers we should instead allow those wanting to pay for these elective surgeries, to pay for them! Drive money into healthcare, scale up treatments, drive money into research. Let the system work.
It's significantly more wicked to pretend that tests, treatments, and more aren't done by healthcare workers (yes, even private ones), and to inundate them with unimportant medical procedures while truly sick people are dying.
Yes, this is true even if the person opting for the elective surgery has millions, potentially even billions of dollars to pay with. Having money doesn't make your illness more important.
Don't get all holier-than-thou on topics like this; it's already a difficult-enough topic.
I often wonder if people who make these kinds of statements simply don't know how market forces work, or if they know how market forces work but just choose to pretend they don't exist in certain contexts where that reality feels particularly unfair...
Demand suppression doesn't work. "Having money doesn't make your illness more important" sounds like a noble sentiment, but by applying it in the real world you'd actually be reducing the total size of the pool of resources available to treat everyone. Talk about holier than thou...
Of course I know how market forces work. They are not the only forces we can manage. They are not the only levers we can pull. Economics are cool, but not almighty. There is no scenario in which a hospital gets extra profit, and turns around and simply reduces the cost for those in need. No - no additional resources are being removed. That's not how hospitals work.
> It's significantly more wicked to pretend that tests, treatments, and more aren't done by healthcare workers (yes, even private ones), and to inundate them with unimportant medical procedures while truly sick people are dying.
Strawman+ad hominem. No one is suggesting to pretend _anything_. Charge premiums for these tests based on how "unimportant" they are. Use market forces to move money from those willing to pay, to those who cannot.
Actually neither - you were suggesting that money makes the problem valid. It doesn't. You can charge all you want - it either becomes useless (why are we trying to find ways to get more profit to hospitals???) or it reduces the staff who are better suited to go somewhere else.
This is an unbelievably inefficient way to try and move money to those who need it. The market correction should be elsewhere.
It also has to make financial sense, everyone's insurance would be much higher, cancer treatments are $$$, in countries with a public healthcare system it's a no go
It cheaper to treat cancer if it's caught early. Reduced screening isn't reducing the need for cancer treatments - everyone who has cancer still has cancer. You might get an increase in follow up tests due to false positives, but these are cheap.
Because everything is mostly following on local purchasing power. You can build a beautiful modern house in buttfuck nowhere Belarus for 20% of what you'd pay for the same exact house in Germany.
The screening isn't even the problem, finding you have _a_ cancer is one thing, pinpointing where it is, how to treat it, treating it and recovering from it cost orders of magnitude more than the initial diagnosis.
The point I was trying to make was that cancer screening is expensive only because we have a highly inefficient healthcare system. (India was an example and their healthcare system has its own flaws) Sure we can point to PPP, but the reason why screening is that cheaper elsewhere is not ONLY because of PPP. Since you mentioned Germany, public health insurance covers early detection cancer screen every 3 years (2 for skin cancer) once you’re 35. The concern about “raising insurance costs significantly for everyone” in US only exists because of the way healthcare is set up here. It shouldn’t be that expensive to screen and it shouldn’t be that expensive to treat.
> You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason.
The idea that a position of authority means ~anything~ anymore is completely ridiculous.
What did the medical field do to earn such credibility with you? Any intelligent person should have developed a high degree of skepticism regarding the operations of the medical field as of 2025.
> What did the medical field do to earn such credibility with you?
For oncology? A whole lot. It's actually miraculous what they've developed to treat cancer. Cancer treatment has gotten so good that it's common for oncologists to caution against the 5 year study survival rates due to new and better treatments rapidly coming online. A 5 year study is necessarily 5 years out of date.
Medicine isn't a unified field. Having broad skepticism is an irrational position as there's a huge difference between the oncology field and the nutrition field.
There truly are experts in areas we can't--or shouldn't--all try to duplicate ourselves. Civilization is advanced by specialization. We identify these experts with a reputation system so you might call them authorities.
Similarly, there truly are institutions that have decades or more of people, procedures and culture to benefit society and a track record of these benefits.
The malicious erosion, by propaganda and by rhetoric, of the public's trust in our authorities and institutions is one of the biggest crimes of this century.
It wasn't propaganda and rhetoric which eroded the public's trust. It was repeated attempts by authorities to argue based on their authority, instead of using their knowledge to actually make compelling arguments. When inevitably these experts and institutions got things wrong, they lost credibility because they staked their credibility.
We were never supposed to listen to experts because they were experts, experts were supposed to make good points people would listen to. It's shocking that we've grown so accustomed to crappy institutions that we've forgotten what a properly functioning institution even looks like.
> The idea that a position of authority means ~anything~ anymore is completely ridiculous.
In that case, should we just get rid of licensure for professional engineers while we're at it? No special education or experience needed to build a bridge, nuclear reactors, or life-critical systems... since authority is meaningless now in the age of the internet?
The medical field isn't perfect, but it's hubris to believe that most people will perform better at treating disease than somebody with 11 years (minimum) of specialized education and countless hours of experience in a real clinical setting.
There's a pretty stark difference between medical science, medical practitioners, and medical institutions.
Medical science has done a lot to earn credibility over the last couple hundred years. It fully eliminated a disease that was a leading cause of death in multiple human civilizations. It reduced rates of infant mortality by staggering numbers. It created vaccines and surgeries that have each saved countless lives and effectively cured life-altering disabilities and injuries, and demoted tons of diseases from death sentences to mere manageable disabilities or even mild temporary inconveniences
Medical practitioners are a mixed bag that ranges from total altruists to total mercenaries. Most people can learn a skill and incentivizing any skill via things like money or social status creates some goal-misalignment, but also dramatically increases the prevalence of the skill and also the community surrounding it, including research, pedagogy, and infrastructure. I think there's considerable value in not automatically trusting every medical practitioner, but on the whole many of them have earned credibility
Medical institutions have mostly been responsible for the existence of trustable practitioners and research, though in the rich world and especially the US specifically there are significant misalignments that come from capture from power-hungry parties in both government and the private sector. The American medical establishment in particular seems at this point near unsalvageable, having broken so badly that it often deliberately tanks quality of care to enforce state power or to turn a profit. We should probably rethink a lot of how institutions fund research, administer hospitals, prioritize care, act as financial buffers, what legal and enforcement authority we vest in medical practitioners sanctioned by the institutions, etc. So I agree with you there, especially in the United States specifically, though much of this was apparent well before 2025 (practically before I was born)
That's kind of like saying that there is diabetes in your body every single day, and your body handles it just fine by producing insulin. Obviously that statement is nonsensical and essentially devoid of any useful insight.
I'm not even going to comment on this: "You're not a doctor, you're not qualified to tell the difference", because this is such a weird statement that I don't understand how anybody could utter it on this website.
If that is your standard for critical thinking, you are paving the way for anti-science rhetoric to dominate public discourse.
Treat people like stupid idiots if you want but then don't be surprised by the way they vote in elections as a result.
It's literally true that cancerous cells happen all the time in our bodies and no treatment is necessary because the immune system handles it. The ideal diagnostic test would only detect cancers that need intervention.
I won’t even get into the irony of you not realizing that not all forms of diabetes are related to insulin (diabetes insipidus) while simultaneously claiming that you don’t need to be a doctor to be qualified enough to make complex medical decisions.
In the first place, the analogy is wrong. You need insulin, you need blood sugar. Both SHOULD be present. Cancer never SHOULD be present, it just happens to be there often, like any other thing your body clears out.
Edit: the word “diabetes” originally comes from a word meaning “to pass through”. Literally the only thing linking all diabetic conditions is needing to pee a lot
That's amazing, and also totally misses the point, but I guess it let's you keep feeling smug, so that's a plus. If you’re aiming for the full "ackchyually guy" meme, mission accomplished. Meanwhile you’re not touching the core of my argument: we’ve already seen what happens when you lecture people to “trust the science” instead of actually engaging with them. They just go vote for someone who will talk to them, and that’s exactly how you end up with a Kennedy in charge.
Chill out...the most condescending comment here by far is yours, and the "well ackchually" that sent the thread of the rails is your comparison between cancer cells and needing insulin. If you don't want people to poke holes in an analogy like that don't make it.
This entire comment is you whining, but not clarifying whatever point you seem to think I've missed. I'm happy to engage with you, if you have something of substance to add?
>> If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things
They said detecting. Diagnosing is "hey, somethings wrong or odd, what is going on." Detecting is looking for something you otherwise may not ever notice. Not a doctor, just offering my definitions of two different words being used here.
The rise in the preventative screening centers (such as prenuvo) that offer whole body MRIs will be interesting.
The research seems split on if it is worth it or just causes unneeded worry. Obviously if you catch something early then that is great, but there are a lot of people who have a ton of followup testing only to find out there is no issue.
There are also limitations with the level of detail a full body MRI can capture.
I could see it becoming similar to a colonoscopy where you get it like when you turn 30 or something and then every 5-10 years after that.
As part of my post-cancer screening, I have received a full-body MRI every year since 2017. In 2024, it discovered pancreatic cancer. Grateful for those years where it found nothing, but even MORE grateful when it did catch something!
"The rise in early-onset cancer incidence does not consistently signal a rise in the occurrence of clinically meaningful cancer. While some of the increase in early-onset cancer is likely clinically meaningful, it appears small and limited to a few cancer sites. Much of the increase appears to reflect increased diagnostic scrutiny and overdiagnosis. Interpreting rising incidence as an epidemic of disease may lead to unnecessary screening and treatment while also diverting attention from other more pressing health threats in young adults" [1].
The argument against screening is kind of like if you had a really inept fire department that ended up crashing the firetruck into other vehicles and buildings every time they were dispatched... and instead of figuring out how to have the fire department respond to calls in a better and safer way, you ban smoke detectors because then the fire department will only be called after buildings are confirmed to be already engulfed in flames.
“Dr. Welch said the number of unnecessary diagnoses could be lessened if doctors did less routine testing — and if doctors held back from pursuing every abnormality in asymptomatic patients.”
The term cancer refers to hundreds of different tumors with widely various prognosis. The type and especially the differentiation play the crucial role. Such statistics are difficult to present.
In the case of autism the scientists believed that it increased lately but more careful research showed that this was due to early diagnosis.
Medical reasoning is complex. It typically needs to consider second and third order effects (typically, how the public responds to a policy needs to be considered when updating the policy). It can't simply attempt to maximize the global health utility function (ethics, budgets, politics, and human behavior all get in the way).
If your reaction to something like this is an offhand "why don't you just...", or "experts don't matter", or "my grandma told me not to eat sugar because it feeds cancer", please, take a deep breath, and think twice before starting to argue with folks about this.
Consuming foods rich in antioxidants may help. "Research suggests that free radical molecules can add to the risk of health issues linked to aging. Some examples are heart disease, age-related macular degeneration, Alzheimer's disease and cancer." https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...
On the other hand, it's known that consuming the antioxidant vitamin E actually promotes the progression of lung cancer. Cancer cells are under oxidative stress so antioxidants can help them survive and grow.
Just goes to show that biology is WAY more complicated than "if you want to prevent X then do Y" - especially at microbilogical scale. Genes influence each other for example, so by up- or downregulating stuff you are interfering in a highly complex, non-linear system with complex consequences.
The Vitamin E / NAC relationship are interesting. As far as I understand, there needs to be a balance of anti-oxidants (C, E, Selenium, etc). To make it worse there are so many formulations of Vitamin E you can buy (tocopherols, tocotrienols, etc). Sometimes its hard to tell from the studies what forms exactly were being used.
You may also find this interesting:
"NRF2 activation is a predictor of poor clinical outcomes in lung cancer. Given the widespread use of NRF2-inducing compounds such as resveratrol and sulforaphane, these findings raise important concerns about their safety in individuals at risk for or living with cancer."
>The problem is that it is impossible to know if someone’s cancer will be deadly or not.
And that is the issue, I know 2 people who developed cancers when they were around 40, one died, the other person survived but had to be treated. So we close our eyes and hope for the best ?
And I'm sure neither were one of the cancers discussed in the article as candidates for lower screening. Nobody's suggesting we stop looking for lung cancer or any of the other many deadly ones. OTOH, increased screening for thyroid cancer had 0 impact on life expectancy in South Korea.
They ARE suggesting such things (including forms of "not looking") even for deadly ones. In these cases, it is couched in terms of what follow-up is "deemed necessary" (see later) depending on stage classification of that cancer. There is a range of responses that's possible and new research and procedure advancement coming online on a 5-yearly basis in addition to variations in capabilities from hospital to hospital - so a pretty volatile environment - yet the staging recommendation gets changed often based on what health care professionals estimate they can sustain society-wide - i.e. manpower - rather than what might be optimal from a survival point of view for that patient.
To pick one specific example, skin cancer visual screening seems currently recommended on a frequency based not on the speed of evolution of, say, melanoma - which can start and evolve pretty fast -, but on the manpower availability of dermatologists.
Surely it has nothing to do with the proliferation of chemicals and microplastics into the ecosystem, water, food, etc. That would be absurd, after all, a Monsanto-sponsored study found that their pesticides are totally safe.
It's from a dramatic rise in inactive lifestyles by younger people and a lot of sitting, with the predictable consequences. Behavior which would have been far less common before mass adoption of video games and personal computing in the home, and then everybody sitting/laying around their homes with their smartphones. Young people go out less, they have a lot less sex, they're far less social in-person. It all goes together.
These people under 50 were the first generation to sit around at home for long periods of time playing video games. The NES came out in 1985-86 in the US and home video gaming has been mass adopted since. From there add on the full adoption of sitting down at a computer for work in offices across the 1980s and 1990s. Then throw in the full adoption of home computing in the 1990s with Win3 & Win95 + GUI. And for the past 20 years, throw in the smartphone.
It's the sitting primarily, hours and hours of it every day.
I don’t drink, I never smoked, I eat clean, I run, I swim, I go to the gym. But I’m also at my desk for 13 hours a day on average and I think it will kill me one day. Trying to stand as much as possible but it’s not always possible,
"Some cancer specialists counter these concerns, saying the surge in diagnoses is primarily a surge in detecting cancers that did not need to be found..."
This seems excessively paternalistic. If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things, it leaves patients with no way to discover life-altering information about their own health.
If the cancer is not clinically significant, then its not life-altering information.
Essentially they are saying that many of these diagnoses are potentially false positives. To the point where detecting them might be more harmful then not. Keep in mind most cancer treatments are pretty harsh. They are better than cancer, but if you don't have clinically significant cancer then the treatments can be very not worth it.
Then here's an idea: instead of hiding that information, you can explain it to the patient.
You have no authority to treat your patient like a child.
disclosing information is not a medically neutral act. Knowing you have a medical condition can create a great deal of anxiety and anguish and prompt lots of tests. If the result of all those tests and anxiety is "no action indicated," you've basically given your patient a condition that reduces their quality of life for no upside.
I once had a misdiagnosis of an incurable illness that I didn't actually have, and the stress of dealing with that caused me to develop another, very real medical condition that took a year to get under control.
Hypothetically (totally made up numbers), if a positive result on the test means there is 1/10000 chance you have cancer, and negative result means a 1/20000 chance, with the test also having a 1/1000 chance of giving the patient an adverse reaction, i think the questions most patients would ask is why was the test run in the first place?
We're not talking about hiding information, we're talking about not looking for it in the first place. Information that is costly to acquire but not actionable once acquired.
in some cases the knowledge itself is a curse. These commenters mostly have no clue what they’re talking about and it shows.
My spouse found out they had a benign brain tumor, an accidental discovery while doing a brain scan for some other reason. She now has to get annual scans done to make sure the size doesn’t change. Guess what? It hasn’t changed in 5 years.
You might say “better safe than sorry!” To that i say - bullshit. It’s caused her lots of unnecessary stress and anxiety. EVERY year she goes back to the testing center and stresses out about if it’s changed in the last year. She sleeps poorly sometimes because of the anxiety, etc. Knowing every microscopic issue within your body is not always a net benefit! Quality of life matters too, not just longevity.
I think it really depends on the type of cancer. Actionable information is the most useful information.
I believe you’d have a very different opinion if the size did change and she had the opportunity to treat it at a very early stage.
I’ve thought about this.
According to this source, “Approximately 72% of all brain tumors are benign”. https://braintumor.org/brain-tumors/about-brain-tumors/brain...
So my wife has gone through all this extra stress to MAYBE catch a cancerous tumor (28%). That’s assuming it grows large enough to impact her before she dies naturally. And I see that the survival rate of some brain tumors, even if found very early, is very poor (5-10% for some tumors, like glioblastoma).
Lots of “what if’s” here. And for what? All i’m arguing is, knowledge is not always actionable, and what’s not actionable can keep you up at night.
The point i’m making is, we should not be trying to pursue a life of 0 risk and perfect decisions. Life is filled with risk (and good and bad luck). That’s just life.
It depends on your personality or worldview. Some people would be much more comfortable lowering their chances of “what ifs” than leaving it all to fate.
i agree with you. If a patient expresses that sentiment to their doctor, they should act accordingly and order the extra screening. At the end of the day it should be a conversation with your provider.
There should definitely be an honest discussion about pros and cons. And not just the physical, but the mental aspect as well.
Nocebo [1], a well know/documented phenomenon, can be very damaging.
[1] https://en.wikipedia.org/wiki/Nocebo
On the other hand, the placebo effect works even when the placebo is clearly labelled "placebo". So I guess there's potential to tell people needlessly disconcerting facts and then take the edge off with reassuring bluster and functionless comforts.
This is a "why don't you just" answer. The reason the establishment does this is that we know the outcome of telling people is worse than not telling them. This is an expensive lesson learned over over a century of medical treatment.
Outside of an emergency I would prefer "first, fully inform" to "first, do no harm", acknowledging the potentially mortal cost.
What if you had stats that showed that (the fully inform) policy produced more negative results?
Would you insist on fully informing if the outcome was, on average, worse? If so, why?
Yes, because I have met many doctors whose judgement I profoundly mistrust, and prefer my own. Sometimes their whole paradigm is flawed, but sometimes they're just not informed about my own values. And I would rather die by my own misjudgment than theirs.
OK good luck when you get real sick! Because that's what you'll be depending on.
I'm an old guy, it's happened several times. The last time, a surgeon removed a tumor, found that it was malignant ... and then told me that it was no big deal, it was a kind of cancer that would not have caused serious problems. She said if she had to get cancer she'd pick this kind. I wish she had told me that before the surgery. I may have had it anyway, but maybe not. Wouldn't you value being fully informed more after that? Surgeons have as much of a conflict of interest when selling their own services as anyone else.
I'm not sure what your point is. This discussion is about medical researchers making decisions on thousands or millions of patients in aggregate... what you're describing is a common thing (don't know how bad a tumor is until it's removed).
The doctor didn't know that before removing the tumor (almost certainly; the alternative is medical fraud).
Doctors going into uber salesman mode selling dangerous surgery is super common. So very common among heart surgeons it’s comical. Point is, blindly trusting doctors and their judgements will in all likelihood just turn you into a sickly perma patient.
Also, if the outcome is worse by informing, doesn't that imply a violation of "first, do no harm"? Which, to be fair, the OP says they wouldn't prioritize...
Depends on how you interpret: "First do no harm". Is that an obligation to minimize the harm to an individual patient? Or is the goal to maximize the health of many patients? Like I've said elsewhere, medical reasoning is subtle.
That could be true, but it isn't, since we don't always know at the individual level if a specific tumor is harmless at the moment of diagnosis.
You could say the same thing about diagnosing cancer via astrology.
A test that with low specificity is simply not a useful test.
> we don't always know at the individual level if a specific tumor is harmless at the moment of diagnosis.
You didn't know prior to the test either.
We don't know if a tumor is harmless, but we do know that treatment has significant harm. Radiation and chemotherapy are nasty. We also know that the stress of a positive diagnosis has significant harm.
First do no harm.
I agree. I wouldn't contest "cancers that did not need to be treated", but this would imply finding, following, and deciding if the tumor needs treatment.
Not needing to be found sounds like cost saving, leave that to the accountants.
There is cancer in your body every single day. Your immune system handles it just fine. There is an explicit difference between cancer that needs treating and cancer that should be ignored because it's a waste of time and resources to treat. You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason.
We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.
My father has a high rate PSA change a few years ago so I learned everything I could about prostate cancer for about 4 weeks.
I then talked to several doctors I know (family practice and two internal medicine).
It was embarrassing how little they knew. And even more shocking actually, is how wrong they were about things.
Two of them told me the risk of infection from a prostate biopsy was basically zero. I asked for clarification with actual numbers, and even led them with "for what kind? Like 1 in 100 or 1 in 1000?"
One said basically zero, the other said 1 in a million.
Neither knew to mention the two common types, and to make sure we go with the one type that carries less risk of infection.
Even then, the less risky one is about 1 in 1000. If you have bad insurance you might go with the older type which is about 1 in 100. And that's with them giving you antibiotics beforehand....
Basically they got everything I asked about wrong compared to specialists you can read online.
Ps, my dad got an MRI with two 1cm growths.
He changed his diet and added fasts, and did nothing else. His doctor basically writing him off in anger.
5 years later, PSA lower than before the incident. Paid for a scan last year, zero growth.
Internet/YouTube experts/doctors really do beat most general doctors. The odds of you having someone in the top 10% of their field, let alone top 1-2% in your local town is pretty low. Even my bay area doctor friends work at pretty basic general bay area hospitals. Imagine who's left in Modesto, CA.
I'm glad your dad got better, it had nothing to do with his diet and fasting. It's no different than Steve Jobs stubbornly becoming a fruititarian to treat his cancer. If his immune system had fought it off, then fruit would be a cancer cure and all his doctors would be idiots.
Youtube/Internet experts are one of the largest propagators of medical misinformation and are actively harming people every day, and if I've ever been in favor of restricting free speech, it's giving out medical advice without a license. If we can restrict giving legal advice, and everyone understands how painfully stupid you'd have to be to represent yourself in court without a law degree, then we can restrict giving medical advice, and hopefully people can realize how painfully stupid you'd have to be to manage your own medical treatments without a medical degree.
Regarding Steve Jobs, that's unfortunate for him because even my grandmother in Poland used to say "sugar causes/feeds cancer" when she tried to get us to stop sweetening our tea back in the 80s before we left.
Somehow she knew what several doctors and researchers are now documenting, that cancer cells have a much harder time growing without ample amounts of glucose.
Oh great, another expert. Except without the 30 years of research and experience.
One guy wins the nobel prize for detailing a function of fasting and its effects on the immune system and cell repair/death... But fasting doesn't help! We know this, because a guy on hacker news said so.
Your response is a non-sequitur. The original statement was about intentionally not detecting cancer. You are talking about whether the cancer is medically necessary to treat.
You are just assuming that all cancer must be treated if detected, even if it is medically unnecessary, therefore we must not detect medically insignificant cancer which would be net harmful to treat. You can detect things and determine no action should be taken. I can understand if that might be the modern standard of care, but if so then that is the problem; not early detection of cancer, which could be medically insignificant, but which may also allow the early detection of medically significant cancer.
I'm pretty sure every medical show had an episode where the "money-grubbing hospital admin" character want to start selling full body medical scans, and the "very well-respected and honor-bound doctor" character points out how this is quite literally one of the most useless and corrupt ways for a hospital to make money.
There are probably a dozen things wrong with your body right now. That doesn't mean they're even affecting you. While you may have some type of cancer that is at the absolute first day of detectability, or a bone slightly out of place, or a weird spot on your heart, someone else has a case that is 6 months deeper and needs more dire treatment.
There is zero benefit to society to massively overburden our healthcare system (this is true of any nation) by searching constantly for random problems that may or may not exist.
If there were good reason to do this, you'd have regularly-scheduled checkups, like with colon or breast cancer.
at the same time you have endless stories of people losing family and friends to cancer because a doctor dismissed complaints as anxiety or needing to exercise more leading to cancer not being discovered until it was too late to treat.
The answer can't be to put our collective heads in the sand.
Perhaps BOTH the "money-grubbing hospital admin" and the "very well-respected and honor-bound doctor" are wrong for not involving their patients in these decision? And their insurance for that matter.
Recently my US-system, world-ranking university hospital complex was first convinced that my insurance would not pay for XXX (and consequently did not recommend it and delayed it). Then after I insisted and got that done, they told me how surprised they were (1) that my (US) insurance did in fact cover every single bit of everything we eventually got done and (2) how MUCH that same US insurance in fact paid them for each of the bits. On the first try. That insurance company has horrible problems, but I can't complain that they didn't cover the hell out of the thing. You know - on the same year we read everyone else's horror stories.
The whole system is very sick.
You also have the issue of information creating liability. A thing that nobody knows about is nobody's problem, a thing that COULD be a problem but probably isn't in someone's professional judgement creates liability for the decision maker.
It's a human factors thing. If two patients both have a cancerous tumor that does not need treatment, the patient that did not have a screening is better off. The patient who was screened will deal with anxiety from having a positive screening result in addition to any negative effects from the screening and follow ups. Many patients are not comfortable living with a detected tumor, even if the standard of care is to watch and wait. Of course, the opposite scenario is also true --- if both patients have a tumor were removal would be best, the one that gets screened has a better outcome.
Maybe if we were all pretty rational people, we could better manage positive screening results and follow up actions that lead towards taking no specific action; but that's not where people are at the moment.
There's a tradeoff of early detection of fast growing tumors that are likely to cause issues vs detection of slow growing tumors that are likely to not cause issues except if they're detected. You can see how the consensus is shifting on things like breast, prostate, and colon cancer screenings over time. My TLDR is that we developed tools and methods, started applying them and have generally reduced the screening frequency over time as we understand more about the tradeoffs.
Except that the medical system already does that for various types of common cancer screening such as breast cancer. It is frequently detected extremely early when it is medically insignificant and patients may be recommended to just wait and watch with more frequent screening. Increased vigilance would have been impossible without early detection and early detection for breast cancer is viewed very positively and is very positive for society.
We have a system that partially results in anxiety because cancer screening is frequently only done when cancer would already be medically significant. A positive result usually means medically significant cancer because as a society we already chose to not screen when it would be medically insignificant. This is perfectly reasonable if the test is expensive, inaccurate, or harmful as even just the harms from doing the test in bulk could result in societally worse outcomes than occasional early detection. However, the rise in "medically unnecessary" screening indicates that we have turned the corner on that in many cases; that or it is easily billed corruption which is a separate problem.
What determines if a cancer should be treated is the type, size, growth, and age of a patient.
Type and size and growth you can't find out without doing some sort of test/screening.
I agree that oncologists are ultimately who should be making the call on what needs to be treated and how. But I think your characterization of how common non-dangerous tumors are is off.
> We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.
Strawman. No one is suggesting adding extra stress to healthcare workers. It's also not you or your doctors call to make: let's gatekeep this patients cancer because our hospital can't deal with the workload. What a truly wicked idea.
To help alleviate the extreme shortage of available healthcare workers we should instead allow those wanting to pay for these elective surgeries, to pay for them! Drive money into healthcare, scale up treatments, drive money into research. Let the system work.
Don't just turn off the lights and shut the door.
It's significantly more wicked to pretend that tests, treatments, and more aren't done by healthcare workers (yes, even private ones), and to inundate them with unimportant medical procedures while truly sick people are dying.
Yes, this is true even if the person opting for the elective surgery has millions, potentially even billions of dollars to pay with. Having money doesn't make your illness more important.
Don't get all holier-than-thou on topics like this; it's already a difficult-enough topic.
I often wonder if people who make these kinds of statements simply don't know how market forces work, or if they know how market forces work but just choose to pretend they don't exist in certain contexts where that reality feels particularly unfair...
Demand suppression doesn't work. "Having money doesn't make your illness more important" sounds like a noble sentiment, but by applying it in the real world you'd actually be reducing the total size of the pool of resources available to treat everyone. Talk about holier than thou...
Of course I know how market forces work. They are not the only forces we can manage. They are not the only levers we can pull. Economics are cool, but not almighty. There is no scenario in which a hospital gets extra profit, and turns around and simply reduces the cost for those in need. No - no additional resources are being removed. That's not how hospitals work.
TaLk aBoUt hOlIeR ThAn tHoU....
> It's significantly more wicked to pretend that tests, treatments, and more aren't done by healthcare workers (yes, even private ones), and to inundate them with unimportant medical procedures while truly sick people are dying.
Strawman+ad hominem. No one is suggesting to pretend _anything_. Charge premiums for these tests based on how "unimportant" they are. Use market forces to move money from those willing to pay, to those who cannot.
Actually neither - you were suggesting that money makes the problem valid. It doesn't. You can charge all you want - it either becomes useless (why are we trying to find ways to get more profit to hospitals???) or it reduces the staff who are better suited to go somewhere else.
This is an unbelievably inefficient way to try and move money to those who need it. The market correction should be elsewhere.
At a population level, that makes sense.
But, as the article notes, we don't know if any particular cancer will kill an individual.
It's a conundrum. But, "Meh, let's not test since it might not kill you." doesn't feel like the right answer.
It also has to make financial sense, everyone's insurance would be much higher, cancer treatments are $$$, in countries with a public healthcare system it's a no go
It cheaper to treat cancer if it's caught early. Reduced screening isn't reducing the need for cancer treatments - everyone who has cancer still has cancer. You might get an increase in follow up tests due to false positives, but these are cheap.
Ehh. It’s only that expensive because we let be. You can get a basic cancer screen in India for 2500 rupees which is about $35.
Because everything is mostly following on local purchasing power. You can build a beautiful modern house in buttfuck nowhere Belarus for 20% of what you'd pay for the same exact house in Germany.
The screening isn't even the problem, finding you have _a_ cancer is one thing, pinpointing where it is, how to treat it, treating it and recovering from it cost orders of magnitude more than the initial diagnosis.
The point I was trying to make was that cancer screening is expensive only because we have a highly inefficient healthcare system. (India was an example and their healthcare system has its own flaws) Sure we can point to PPP, but the reason why screening is that cheaper elsewhere is not ONLY because of PPP. Since you mentioned Germany, public health insurance covers early detection cancer screen every 3 years (2 for skin cancer) once you’re 35. The concern about “raising insurance costs significantly for everyone” in US only exists because of the way healthcare is set up here. It shouldn’t be that expensive to screen and it shouldn’t be that expensive to treat.
https://www.informedhealth.org/what-screening-tests-does-ger...
Some tests are cheaper than others in any market.
And some markets in their entirety are cheaper than others because life saving care isn't marked up a 1000%.
> You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason.
The idea that a position of authority means ~anything~ anymore is completely ridiculous.
What did the medical field do to earn such credibility with you? Any intelligent person should have developed a high degree of skepticism regarding the operations of the medical field as of 2025.
> What did the medical field do to earn such credibility with you?
For oncology? A whole lot. It's actually miraculous what they've developed to treat cancer. Cancer treatment has gotten so good that it's common for oncologists to caution against the 5 year study survival rates due to new and better treatments rapidly coming online. A 5 year study is necessarily 5 years out of date.
Medicine isn't a unified field. Having broad skepticism is an irrational position as there's a huge difference between the oncology field and the nutrition field.
This opinion makes me sad.
There truly are experts in areas we can't--or shouldn't--all try to duplicate ourselves. Civilization is advanced by specialization. We identify these experts with a reputation system so you might call them authorities.
Similarly, there truly are institutions that have decades or more of people, procedures and culture to benefit society and a track record of these benefits.
The malicious erosion, by propaganda and by rhetoric, of the public's trust in our authorities and institutions is one of the biggest crimes of this century.
It wasn't propaganda and rhetoric which eroded the public's trust. It was repeated attempts by authorities to argue based on their authority, instead of using their knowledge to actually make compelling arguments. When inevitably these experts and institutions got things wrong, they lost credibility because they staked their credibility.
We were never supposed to listen to experts because they were experts, experts were supposed to make good points people would listen to. It's shocking that we've grown so accustomed to crappy institutions that we've forgotten what a properly functioning institution even looks like.
> The idea that a position of authority means ~anything~ anymore is completely ridiculous.
In that case, should we just get rid of licensure for professional engineers while we're at it? No special education or experience needed to build a bridge, nuclear reactors, or life-critical systems... since authority is meaningless now in the age of the internet?
The medical field isn't perfect, but it's hubris to believe that most people will perform better at treating disease than somebody with 11 years (minimum) of specialized education and countless hours of experience in a real clinical setting.
There's a pretty stark difference between medical science, medical practitioners, and medical institutions.
Medical science has done a lot to earn credibility over the last couple hundred years. It fully eliminated a disease that was a leading cause of death in multiple human civilizations. It reduced rates of infant mortality by staggering numbers. It created vaccines and surgeries that have each saved countless lives and effectively cured life-altering disabilities and injuries, and demoted tons of diseases from death sentences to mere manageable disabilities or even mild temporary inconveniences
Medical practitioners are a mixed bag that ranges from total altruists to total mercenaries. Most people can learn a skill and incentivizing any skill via things like money or social status creates some goal-misalignment, but also dramatically increases the prevalence of the skill and also the community surrounding it, including research, pedagogy, and infrastructure. I think there's considerable value in not automatically trusting every medical practitioner, but on the whole many of them have earned credibility
Medical institutions have mostly been responsible for the existence of trustable practitioners and research, though in the rich world and especially the US specifically there are significant misalignments that come from capture from power-hungry parties in both government and the private sector. The American medical establishment in particular seems at this point near unsalvageable, having broken so badly that it often deliberately tanks quality of care to enforce state power or to turn a profit. We should probably rethink a lot of how institutions fund research, administer hospitals, prioritize care, act as financial buffers, what legal and enforcement authority we vest in medical practitioners sanctioned by the institutions, etc. So I agree with you there, especially in the United States specifically, though much of this was apparent well before 2025 (practically before I was born)
People have a right to make their own medical choices. Saying on people with the correct credentials should have input is offensive.
> you're not in the medical field
citation needed
That's kind of like saying that there is diabetes in your body every single day, and your body handles it just fine by producing insulin. Obviously that statement is nonsensical and essentially devoid of any useful insight.
I'm not even going to comment on this: "You're not a doctor, you're not qualified to tell the difference", because this is such a weird statement that I don't understand how anybody could utter it on this website.
If that is your standard for critical thinking, you are paving the way for anti-science rhetoric to dominate public discourse.
Treat people like stupid idiots if you want but then don't be surprised by the way they vote in elections as a result.
It's literally true that cancerous cells happen all the time in our bodies and no treatment is necessary because the immune system handles it. The ideal diagnostic test would only detect cancers that need intervention.
No, it’s nothing like that.
I won’t even get into the irony of you not realizing that not all forms of diabetes are related to insulin (diabetes insipidus) while simultaneously claiming that you don’t need to be a doctor to be qualified enough to make complex medical decisions.
In the first place, the analogy is wrong. You need insulin, you need blood sugar. Both SHOULD be present. Cancer never SHOULD be present, it just happens to be there often, like any other thing your body clears out.
Edit: the word “diabetes” originally comes from a word meaning “to pass through”. Literally the only thing linking all diabetic conditions is needing to pee a lot
That's amazing, and also totally misses the point, but I guess it let's you keep feeling smug, so that's a plus. If you’re aiming for the full "ackchyually guy" meme, mission accomplished. Meanwhile you’re not touching the core of my argument: we’ve already seen what happens when you lecture people to “trust the science” instead of actually engaging with them. They just go vote for someone who will talk to them, and that’s exactly how you end up with a Kennedy in charge.
Chill out...the most condescending comment here by far is yours, and the "well ackchually" that sent the thread of the rails is your comparison between cancer cells and needing insulin. If you don't want people to poke holes in an analogy like that don't make it.
This entire comment is you whining, but not clarifying whatever point you seem to think I've missed. I'm happy to engage with you, if you have something of substance to add?
>> If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things
They said detecting. Diagnosing is "hey, somethings wrong or odd, what is going on." Detecting is looking for something you otherwise may not ever notice. Not a doctor, just offering my definitions of two different words being used here.
I've seen every single professional field go through boom and bust cycles over the course of my life except one.
It is my dearest dream to see a single bust in the MD profession.
The rise in the preventative screening centers (such as prenuvo) that offer whole body MRIs will be interesting.
The research seems split on if it is worth it or just causes unneeded worry. Obviously if you catch something early then that is great, but there are a lot of people who have a ton of followup testing only to find out there is no issue.
There are also limitations with the level of detail a full body MRI can capture.
I could see it becoming similar to a colonoscopy where you get it like when you turn 30 or something and then every 5-10 years after that.
As part of my post-cancer screening, I have received a full-body MRI every year since 2017. In 2024, it discovered pancreatic cancer. Grateful for those years where it found nothing, but even MORE grateful when it did catch something!
"The rise in early-onset cancer incidence does not consistently signal a rise in the occurrence of clinically meaningful cancer. While some of the increase in early-onset cancer is likely clinically meaningful, it appears small and limited to a few cancer sites. Much of the increase appears to reflect increased diagnostic scrutiny and overdiagnosis. Interpreting rising incidence as an epidemic of disease may lead to unnecessary screening and treatment while also diverting attention from other more pressing health threats in young adults" [1].
[1] https://jamanetwork.com/journals/jamainternalmedicine/articl...
The argument against screening is kind of like if you had a really inept fire department that ended up crashing the firetruck into other vehicles and buildings every time they were dispatched... and instead of figuring out how to have the fire department respond to calls in a better and safer way, you ban smoke detectors because then the fire department will only be called after buildings are confirmed to be already engulfed in flames.
The term is incidentaloma https://en.wikipedia.org/wiki/Incidental_imaging_finding
“Dr. Welch said the number of unnecessary diagnoses could be lessened if doctors did less routine testing — and if doctors held back from pursuing every abnormality in asymptomatic patients.”
I pity this doctor’s patients
The term cancer refers to hundreds of different tumors with widely various prognosis. The type and especially the differentiation play the crucial role. Such statistics are difficult to present.
In the case of autism the scientists believed that it increased lately but more careful research showed that this was due to early diagnosis.
Medical reasoning is complex. It typically needs to consider second and third order effects (typically, how the public responds to a policy needs to be considered when updating the policy). It can't simply attempt to maximize the global health utility function (ethics, budgets, politics, and human behavior all get in the way).
If your reaction to something like this is an offhand "why don't you just...", or "experts don't matter", or "my grandma told me not to eat sugar because it feeds cancer", please, take a deep breath, and think twice before starting to argue with folks about this.
Consuming foods rich in antioxidants may help. "Research suggests that free radical molecules can add to the risk of health issues linked to aging. Some examples are heart disease, age-related macular degeneration, Alzheimer's disease and cancer." https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...
On the other hand, it's known that consuming the antioxidant vitamin E actually promotes the progression of lung cancer. Cancer cells are under oxidative stress so antioxidants can help them survive and grow.
https://www.lung.org/blog/antioxidants-lung-cancers
Just goes to show that biology is WAY more complicated than "if you want to prevent X then do Y" - especially at microbilogical scale. Genes influence each other for example, so by up- or downregulating stuff you are interfering in a highly complex, non-linear system with complex consequences.
Just look at this example of a gene regulation network: https://www.researchgate.net/figure/Different-visualizations...
The Vitamin E / NAC relationship are interesting. As far as I understand, there needs to be a balance of anti-oxidants (C, E, Selenium, etc). To make it worse there are so many formulations of Vitamin E you can buy (tocopherols, tocotrienols, etc). Sometimes its hard to tell from the studies what forms exactly were being used.
You may also find this interesting:
"NRF2 activation is a predictor of poor clinical outcomes in lung cancer. Given the widespread use of NRF2-inducing compounds such as resveratrol and sulforaphane, these findings raise important concerns about their safety in individuals at risk for or living with cancer."
https://link.springer.com/article/10.1007/s11357-025-01736-0
Many people eat high-sulforaphane containing foods for health benefits.
And finally from last week https://newatlas.com/diet-nutrition/vitamin-c-air-pollution-...
This was about 1000mg / day for humans.
Very interesting breakdown from Medlife crisis discussing this: https://youtu.be/BJ9soFmzYO8
>The problem is that it is impossible to know if someone’s cancer will be deadly or not.
And that is the issue, I know 2 people who developed cancers when they were around 40, one died, the other person survived but had to be treated. So we close our eyes and hope for the best ?
And I'm sure neither were one of the cancers discussed in the article as candidates for lower screening. Nobody's suggesting we stop looking for lung cancer or any of the other many deadly ones. OTOH, increased screening for thyroid cancer had 0 impact on life expectancy in South Korea.
They ARE suggesting such things (including forms of "not looking") even for deadly ones. In these cases, it is couched in terms of what follow-up is "deemed necessary" (see later) depending on stage classification of that cancer. There is a range of responses that's possible and new research and procedure advancement coming online on a 5-yearly basis in addition to variations in capabilities from hospital to hospital - so a pretty volatile environment - yet the staging recommendation gets changed often based on what health care professionals estimate they can sustain society-wide - i.e. manpower - rather than what might be optimal from a survival point of view for that patient.
To pick one specific example, skin cancer visual screening seems currently recommended on a frequency based not on the speed of evolution of, say, melanoma - which can start and evolve pretty fast -, but on the manpower availability of dermatologists.
https://archive.ph/NIptp
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Surely it has nothing to do with the proliferation of chemicals and microplastics into the ecosystem, water, food, etc. That would be absurd, after all, a Monsanto-sponsored study found that their pesticides are totally safe.
It's from a dramatic rise in inactive lifestyles by younger people and a lot of sitting, with the predictable consequences. Behavior which would have been far less common before mass adoption of video games and personal computing in the home, and then everybody sitting/laying around their homes with their smartphones. Young people go out less, they have a lot less sex, they're far less social in-person. It all goes together.
These people under 50 were the first generation to sit around at home for long periods of time playing video games. The NES came out in 1985-86 in the US and home video gaming has been mass adopted since. From there add on the full adoption of sitting down at a computer for work in offices across the 1980s and 1990s. Then throw in the full adoption of home computing in the 1990s with Win3 & Win95 + GUI. And for the past 20 years, throw in the smartphone.
It's the sitting primarily, hours and hours of it every day.
I don’t drink, I never smoked, I eat clean, I run, I swim, I go to the gym. But I’m also at my desk for 13 hours a day on average and I think it will kill me one day. Trying to stand as much as possible but it’s not always possible,
> It's the sitting primarily, hours and hours of it every day
...do you have a source for this causative link? It would seem like it's highly testable.