Comment by gumby | Hacker News Reader

Comment by gumby | Hacker News Reader

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> I honestly think we’d catch a lot if we did the same [biennial testing] with blood tests. We’d probably save a lot on healthcare with early detections and corrections.

That is definitely not clear. Also every procedure has iatrogenic risk.

Look at cancer screenings in the USA: they have gotten more precise and more frequent, so more cancers are caught earlier and survival time increased.

Or has it? Since we find smaller tumors, we find ones that might never have metastasized at all, but intervene anyway. Even for the dangerous ones, earlier detection means earlier treatment, but was the patient going to at 50 either way? That just means they are a cancer patient for a longer period, which by the metrics counts as longer survival.

All the grumbling about too much screening doesn’t pass my sniff test. No one can convince me that detecting cancer earlier isn’t, on average, a good thing. The real problem is how expensive our healthcare system is - the cost of even basic screening procedures makes them into a much bigger deal than they need to be.

> No one can convince me that detecting cancer earlier isn’t, on average, a good thing.

Since no one can convince you, indeed you should not bother to read any of the extensive literature on the subject.

But consider that if indeed it does not extend lifespan, but does extend treatment span, patients will suffer a worse quality of life on painful treatment that does not help and the concomitant fear.

A shame, because you finger health care expense and this phenomenon increases health care expense.

Ah, the plebeians are the problem. With more information, the plebeians will make incorrect decisions that make them more miserable. It is better to keep them in the veil of ignorance for their own good.

These are the over-diagnosis bias and the lead-time bias for anyone interested in learning more.

The book Risk Savvy by Gerd Gigerenzer has a chapter that does a good job of covering these. The entire book is worth a read.

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