We are able to early detect these cancers right now with routine targeted imaging. Perhaps we should be working to solve or improve on the drawbacks associated with doing this, some of which are:
CT scans emit ionizing radiation.
MRI contrast can buildup and be retained in the body over repeated administrations.
The scans can produce false positives, surface benign abnormalities which result in a wild goose chase, cause severe patient anxiety and healthcare burden, and result in over-treatment.
And of course doing this on a whole population level is not cost or time effective.
If you look at what practitioners and informed epidemiologists are saying the incidentaloma problem for any type of screening is huge and underestimated with no clear solution. It’s not only about finding and invasively testing benign masses, which can cause actual serious health problems (the associated anxiety and stress alone can actually kill, not to mention the cost and painful or damaging biopsies). But many true positive cancerous or malignant conditions can progress so slowly relative to the patient’s overall health that they do not shorten the patient’s life and/or the treatment may be worse than the “disease” that was detected. Hence why so many types of screenings that actually work can do positive harm for certain populations.
And once you find something with a screening you can’t unfind it. The patient or at least their doctor now has that knowledge and has to live with it and actively decide what to do about it.
Comments
We are able to early detect these cancers right now with routine targeted imaging. Perhaps we should be working to solve or improve on the drawbacks associated with doing this, some of which are:
CT scans emit ionizing radiation.
MRI contrast can buildup and be retained in the body over repeated administrations.
The scans can produce false positives, surface benign abnormalities which result in a wild goose chase, cause severe patient anxiety and healthcare burden, and result in over-treatment.
And of course doing this on a whole population level is not cost or time effective.
If you look at what practitioners and informed epidemiologists are saying the incidentaloma problem for any type of screening is huge and underestimated with no clear solution. It’s not only about finding and invasively testing benign masses, which can cause actual serious health problems (the associated anxiety and stress alone can actually kill, not to mention the cost and painful or damaging biopsies). But many true positive cancerous or malignant conditions can progress so slowly relative to the patient’s overall health that they do not shorten the patient’s life and/or the treatment may be worse than the “disease” that was detected. Hence why so many types of screenings that actually work can do positive harm for certain populations.
And once you find something with a screening you can’t unfind it. The patient or at least their doctor now has that knowledge and has to live with it and actively decide what to do about it.
It will never be cost or time effective if we never try. I'm paying out of pocket every year for an MRI scan, this was my second year this past year.