Hacker News Reader

Comment by giantg2 | Hacker News Reader

They generally aren't going to give them to everyone. They will give them to everyone within a certain group, such as age 30+ since the under 30 group is very low risk (unless family history, etc). Similar to how they don't test most kids and younger people for cholesterol - it's just not a significant problem for that age group.

View on HN

Traditionally, tests have been metered that way because of costs (expensive reagents, preparation, processing) or side effects (radiation from scans).

But the actual relevant equation is {cost of testing} vs {cost of delayed treatment}

If the cost of testing, in economic and health senses, decreases while the cost of delayed treatment holds constant, a different mass deployment optimal point is created.

Thankfully broader proactive testing is also in insurance companies' financial interests, given the high costs of late stage cancer treatment.

One way to test lots of patients where a) there's a low probability that an individual patient will have the disease and b) the test is expensive is to first mix some of the blood of each of N patients and do one test on the mix. If the batch tests negative then all patients are negative and you've only paid for one test. If the batch tests positive then you have to repeat the test on the remaining blood of each of the N patients to determine which were positive. Thus, with a high probability you only pay for 1 test, and with a low probability you have to pay for N+1 tests. The value of N is easily computed to minimize the overall cost, given the cost of each test and the percentage of patients that have the disease.

I think these days they do recommend screening all children for cholesterol.

Which is good because "ASCVD is a disease that begins in childhood; hence, primordial prevention is an important target for improving cardiovascular morbidity and mortality later in life."

> Elevated LDL-C and triglyceride levels have a positive correlation with atherosclerotic lesion prevalence that persists from childhood through early adulthood... Follow-up data from the Young Finns cohort after 12 and 27 yr also demonstrated positive correlations between elevated childhood serum cholesterol and triglycerides to elevated levels in adulthood... Children from the i3C cohort with high and borderline-high total cholesterol have 1.5 to 2.13 times the risk of both fatal and nonfatal cardiovascular events in adulthood than children without. In addition, i3C children with high and borderline-high triglycerides have 1.69 to 2.47 times the risk than children with normal triglycerides.

https://journals.lww.com/jcrjournal/fulltext/2022/11000/prim...

Nearly everyone will reach 30 in their life, so it is safe to say we give them to everyone. It isn't a one and done test, cancer can form at any time in your life. To be useful we need to give this to everyone over 30 (40, 50....?) , on a regular schedule (yearly?). The article doesn't specify those details (or at least not before I hit the sign in wall)

Reply on news.ycombinator.com