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Comment by smt88 | Hacker News Reader

It's possible (if not likely) that paying for this test made you more likely to die. There are two mechanisms for this:

1) You could develop cancer tomorrow, notice the symptoms, and assume it's not worth getting screened again because you were just supposedly cleared of cancer. A common logical fallacy for our human brains is that we think, "Oh, I just got a test, so it's less likely I have cancer today," which is not how probability works.

2) You could have gotten a false positive, which would have led to unnecessary additional screening. Many methods of cancer screening have some risk, whether from anesthesia, infection, or further false positives leading to unnecessary treatment.

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> A common logical fallacy for our human brains is that we think, "Oh, I just got a test, so it's less likely I have cancer today," which is not how probability works.

Given my interactions with my doctors and their tests, they did seem to hold this belief, too.

In any case, the real mistake people make is failing to update their beliefs when new evidence (symptoms) appears. Rookie mistake. My doctors love to do (or rather, not do) this. Who needs differential diagnosis and re-evaluation when they can just keep the diagnosis and continue receiving a fuckton of money after you based on a secore-based system we have here?

Hyperbole.

I am not going to avoid any reasonable treatment/screen because of it. It was intended to catch asymptomatic cancer. Additional invasive screenings are voluntary and like all treatments they carry risk. I weigh all treatments based on their risks at the time.

For everyday people increased screening of all types has risks, but overall the benefits massively outweigh the risks. If I was a frail 80yo, I might see the risk profile differently.

In my career I've encountered many people who "don't want to know" about medical tests of any kind. I'm not one of those people. Minimally invasive screens early and often please.

> For everyday people increased screening of all types has risks, but overall the benefits massively outweigh the risks.

This is just not how math works, and it's why we still need doctors to order tests -- to protect people from themselves. You clearly don't know what you don't know, but you have a huge amount of confidence that you do, apparently.

Here's a list of different types of cancer screenings and where the risk/benefit falls: https://publichealth.jhu.edu/2023/balancing-the-benefits-and...

The risk of any cancer screening has to be calculated with variables like:

- how risky is the test?

- what are the risks of a false positive?

- how does a true negative affect the person's behavior in the future?

- what is the likelihood that the patient has asymptomatic cancer, based on risks like genetics and age?

- how difficult is the cancer to treat in different stages?

Without looking at all of those things, you don't know if the test is going to increase or decrease all-cause mortality risk.

There are many people, myself included, who don’t want to be patronized or “protected from ourselves” and prevented from accessing data about our bodies.

An MRI, blood test, continuous glucose monitor, etc. carry essentially no intrinsic risk. It’s ridiculous that we need prescriptions for such things.

What I do or don’t do with that data is my prerogative.

The problem is that my tax dollars and insurance dollars pay for people who make mistakes with their own health, so you don't and can never live in a bubble unless you opt out of modern medicine entirely

Prevention is cheaper than treatment.

There has been a lot of talk the last several years about the risks of screening, but in my opinion people have taken this as an opportunity to swing in the opposite extreme. The message shouldn't be "get screened" in the same way the message shouldn't be "if you get screened you're more likely to die".

Not all screening is equal. MRIs for low-back pain often lead to diagnoses of disease followed by unnecessary surgery with high risks. This has led to a reluctancy to prescribe MRIs or other imaging. However, with something like cancer, timing is everything. Months/weeks/days matter and catching a cancer early via a broad screen can be the difference between life and death.

In the case of the galleri test, risk is low and many of the errors can be caught with a re-testing or other non-invasive screen. If my test came back positive I wouldn't be jumping straight into chemo, but would probably get a bunch of bloodwork and some imaging.

At the end of the day, I would much much much rather go through some unnecessary scans due to a false positive than miss a easy to treat cancer because I was scared of the screening risk.

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