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 our hands up in the air and say the problem is too hard.
Better imaging is an option but that often falls into dangerous in itself or easier said than done like say trying to do detection of cancer by scent.
Machine learning is fundamentally GIGO and tends to learn smartass shortcuts if one isn't careful. "The healthy sample data is less zoomed in while the cancer ones are zoomed in - therefore full chest x-ray is fine but a lung X-ray is cancer."
Even then it's really common to see a biopsy come back as 'indeterminate'. If it's indeterminate then now what? You either punt and do nothing or go for excision.
Consider this tidbit: A lot of slow moving low grade cancers it hardly matters when you find them. Early or later matters little. Whereas aggressive cancers often are untreatable. Find them early, find them late you'll die either way. And fast growing cancers often fully develop between screenings.
The point is that there is an opportunity for the Steve Jobs of health care to come up with a way, a new innovative novel way, for classification of tumors to be improved without needing biopsy. Once we have that, then we can take tests to our heart's content. Right now, the attitude of "we shouldn't have people take tests and detect cancer early because our current method of determining if they are cancerous would make it too hard" isn't acceptable.
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.”