This seems excessively paternalistic. If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things, it leaves patients with no way to discover life-altering information about their own health.
Essentially they are saying that many of these diagnoses are potentially false positives. To the point where detecting them might be more harmful then not. Keep in mind most cancer treatments are pretty harsh. They are better than cancer, but if you don't have clinically significant cancer then the treatments can be very not worth it.
You have no authority to treat your patient like a child.
My spouse found out they had a benign brain tumor, an accidental discovery while doing a brain scan for some other reason. She now has to get annual scans done to make sure the size doesn’t change. Guess what? It hasn’t changed in 5 years.
You might say “better safe than sorry!” To that i say - bullshit. It’s caused her lots of unnecessary stress and anxiety. EVERY year she goes back to the testing center and stresses out about if it’s changed in the last year. She sleeps poorly sometimes because of the anxiety, etc. Knowing every microscopic issue within your body is not always a net benefit! Quality of life matters too, not just longevity.
I think it really depends on the type of cancer. Actionable information is the most useful information.
I once had a misdiagnosis of an incurable illness that I didn't actually have, and the stress of dealing with that caused me to develop another, very real medical condition that took a year to get under control.
Would you insist on fully informing if the outcome was, on average, worse? If so, why?
The doctor didn't know that before removing the tumor (almost certainly; the alternative is medical fraud).
First do no harm.
A test that with low specificity is simply not a useful test.
> we don't always know at the individual level if a specific tumor is harmless at the moment of diagnosis.
You didn't know prior to the test either.
Not needing to be found sounds like cost saving, leave that to the accountants.
We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.
I then talked to several doctors I know (family practice and two internal medicine).
It was embarrassing how little they knew. And even more shocking actually, is how wrong they were about things.
Two of them told me the risk of infection from a prostate biopsy was basically zero. I asked for clarification with actual numbers, and even led them with "for what kind? Like 1 in 100 or 1 in 1000?"
One said basically zero, the other said 1 in a million.
Neither knew to mention the two common types, and to make sure we go with the one type that carries less risk of infection.
Even then, the less risky one is about 1 in 1000. If you have bad insurance you might go with the older type which is about 1 in 100. And that's with them giving you antibiotics beforehand....
Basically they got everything I asked about wrong compared to specialists you can read online.
Ps, my dad got an MRI with two 1cm growths.
He changed his diet and added fasts, and did nothing else. His doctor basically writing him off in anger.
5 years later, PSA lower than before the incident. Paid for a scan last year, zero growth.
Internet/YouTube experts/doctors really do beat most general doctors. The odds of you having someone in the top 10% of their field, let alone top 1-2% in your local town is pretty low. Even my bay area doctor friends work at pretty basic general bay area hospitals. Imagine who's left in Modesto, CA.
Youtube/Internet experts are one of the largest propagators of medical misinformation and are actively harming people every day, and if I've ever been in favor of restricting free speech, it's giving out medical advice without a license. If we can restrict giving legal advice, and everyone understands how painfully stupid you'd have to be to represent yourself in court without a law degree, then we can restrict giving medical advice, and hopefully people can realize how painfully stupid you'd have to be to manage your own medical treatments without a medical degree.
Somehow she knew what several doctors and researchers are now documenting, that cancer cells have a much harder time growing without ample amounts of glucose.
One guy wins the nobel prize for detailing a function of fasting and its effects on the immune system and cell repair/death... But fasting doesn't help! We know this, because a guy on hacker news said so.
You are just assuming that all cancer must be treated if detected, even if it is medically unnecessary, therefore we must not detect medically insignificant cancer which would be net harmful to treat. You can detect things and determine no action should be taken. I can understand if that might be the modern standard of care, but if so then that is the problem; not early detection of cancer, which could be medically insignificant, but which may also allow the early detection of medically significant cancer.
There are probably a dozen things wrong with your body right now. That doesn't mean they're even affecting you. While you may have some type of cancer that is at the absolute first day of detectability, or a bone slightly out of place, or a weird spot on your heart, someone else has a case that is 6 months deeper and needs more dire treatment.
There is zero benefit to society to massively overburden our healthcare system (this is true of any nation) by searching constantly for random problems that may or may not exist.
If there were good reason to do this, you'd have regularly-scheduled checkups, like with colon or breast cancer.
The answer can't be to put our collective heads in the sand.
Maybe if we were all pretty rational people, we could better manage positive screening results and follow up actions that lead towards taking no specific action; but that's not where people are at the moment.
There's a tradeoff of early detection of fast growing tumors that are likely to cause issues vs detection of slow growing tumors that are likely to not cause issues except if they're detected. You can see how the consensus is shifting on things like breast, prostate, and colon cancer screenings over time. My TLDR is that we developed tools and methods, started applying them and have generally reduced the screening frequency over time as we understand more about the tradeoffs.
We have a system that partially results in anxiety because cancer screening is frequently only done when cancer would already be medically significant. A positive result usually means medically significant cancer because as a society we already chose to not screen when it would be medically insignificant. This is perfectly reasonable if the test is expensive, inaccurate, or harmful as even just the harms from doing the test in bulk could result in societally worse outcomes than occasional early detection. However, the rise in "medically unnecessary" screening indicates that we have turned the corner on that in many cases; that or it is easily billed corruption which is a separate problem.
Type and size and growth you can't find out without doing some sort of test/screening.
I agree that oncologists are ultimately who should be making the call on what needs to be treated and how. But I think your characterization of how common non-dangerous tumors are is off.
Strawman. No one is suggesting adding extra stress to healthcare workers. It's also not you or your doctors call to make: let's gatekeep this patients cancer because our hospital can't deal with the workload. What a truly wicked idea.
To help alleviate the extreme shortage of available healthcare workers we should instead allow those wanting to pay for these elective surgeries, to pay for them! Drive money into healthcare, scale up treatments, drive money into research. Let the system work.
Don't just turn off the lights and shut the door.
Yes, this is true even if the person opting for the elective surgery has millions, potentially even billions of dollars to pay with. Having money doesn't make your illness more important.
Don't get all holier-than-thou on topics like this; it's already a difficult-enough topic.
Strawman+ad hominem. No one is suggesting to pretend _anything_. Charge premiums for these tests based on how "unimportant" they are. Use market forces to move money from those willing to pay, to those who cannot.
Demand suppression doesn't work. "Having money doesn't make your illness more important" sounds like a noble sentiment, but by applying it in the real world you'd actually be reducing the total size of the pool of resources available to treat everyone. Talk about holier than thou...
But, as the article notes, we don't know if any particular cancer will kill an individual.
It's a conundrum. But, "Meh, let's not test since it might not kill you." doesn't feel like the right answer.
The screening isn't even the problem, finding you have _a_ cancer is one thing, pinpointing where it is, how to treat it, treating it and recovering from it cost orders of magnitude more than the initial diagnosis.
https://www.informedhealth.org/what-screening-tests-does-ger...
100% definitely not lol, you need 2-3 months to see any kind of specialist in germany, 5-10 hours before someone sees you in the emergency room. The healthcare system of every western EU country is getting worse year after year because of the aging population, and on top of that we're taxed more, for shittier services.
I pay 800+ a month and it doesn't even include a yearly blood work unless I beg for it. Just look at your own link, in germany we screen for two cancers for each gender and it's already so fucking expensive, there are dozens of cancers you could theoretically screen for.
Skin cancer screening is actually a good example, we diagnose way more than before, and it has virtually no impact on death stats: https://www.nationalgeographic.com/premium/article/melanoma-...
> More than 80,000 Americans are told each year they have melanoma skin cancer. If that sounds like a lot, it’s because the numbers are six times higher than they were 40 years ago.
> Overdiagnosis is one of the most harmful and costly problems in medicine
That’s like pretty much the standard in the US as well? The unless you’re dying, you’re pretty much in an extremely long wait before you get seen in an emergency room, and then later get sent a $10k+ bill at the minimum. And there’s very few specialists that you can see immediately. In fact, for the majority of people, the step before “how fast can I see my specialist” is the “what specialists are in network”.
And as far as costs are concerned, I pay $2000/month for two people and it will only go up once we have a family of 4. This isn’t even the top tier plan, just a good enough one. Not to mention the thousands of dollars in deductible that you have to pay before the plan kicks in.
And we have an aging population as well. And that’s not going to change regardless of who’s paying for the care.
You’re being taxed for it, we’re paying out of pocket. The only difference is that you get shittier services when taxed, and here you don’t get the care if you can’t afford it. And if you end up in the ER and they have to treat you despite you not having the coverage, the taxpayers cover it anyway.
Correct. It’s faster than getting your PCP to see you and it’s faster than Emergency Room (which GP was comparing the wait times for in other countries). But how much you wait really depends on a lot of factors: how many other patients are sick that day, what time of day are you calling, does the urgent care take appointments, how many urgent care centers are in your area etc. In my area if you call at 8 in the morning and the urgent care you are calling gives out appointments, you’ll probably be seen the same day. You’ll have to wait for your appointment, but once you show up for the appointment, you’ll be seen immediately.
If you’re calling in later (after 10 in the morning) or walking in to a facility, you’ll probably be waiting at least 2-3 hours if you’re lucky. All of this of course comes with higher costs (not as much as ER though).
The problem with urgent care though is that it’s more expensive if you’re running tests and is only designed to fill in for conditions that you’d ideally want your PCP to take care of, but can’t get an appointment for. True emergencies still go to ER. In fact some urgent cares don’t even have equipment like xray or sonography machines, so if you need one, you’d end up in ER anyway. (and get charged for both)
The idea that a position of authority means ~anything~ anymore is completely ridiculous.
What did the medical field do to earn such credibility with you? Any intelligent person should have developed a high degree of skepticism regarding the operations of the medical field as of 2025.
For oncology? A whole lot. It's actually miraculous what they've developed to treat cancer. Cancer treatment has gotten so good that it's common for oncologists to caution against the 5 year study survival rates due to new and better treatments rapidly coming online. A 5 year study is necessarily 5 years out of date.
Medicine isn't a unified field. Having broad skepticism is an irrational position as there's a huge difference between the oncology field and the nutrition field.
There truly are experts in areas we can't--or shouldn't--all try to duplicate ourselves. Civilization is advanced by specialization. We identify these experts with a reputation system so you might call them authorities.
Similarly, there truly are institutions that have decades or more of people, procedures and culture to benefit society and a track record of these benefits.
The malicious erosion, by propaganda and by rhetoric, of the public's trust in our authorities and institutions is one of the biggest crimes of this century.
We were never supposed to listen to experts because they were experts, experts were supposed to make good points people would listen to. It's shocking that we've grown so accustomed to crappy institutions that we've forgotten what a properly functioning institution even looks like.
In that case, should we just get rid of licensure for professional engineers while we're at it? No special education or experience needed to build a bridge, nuclear reactors, or life-critical systems... since authority is meaningless now in the age of the internet?
The medical field isn't perfect, but it's hubris to believe that most people will perform better at treating disease than somebody with 11 years (minimum) of specialized education and countless hours of experience in a real clinical setting.
Medical science has done a lot to earn credibility over the last couple hundred years. It fully eliminated a disease that was a leading cause of death in multiple human civilizations. It reduced rates of infant mortality by staggering numbers. It created vaccines and surgeries that have each saved countless lives and effectively cured life-altering disabilities and injuries, and demoted tons of diseases from death sentences to mere manageable disabilities or even mild temporary inconveniences
Medical practitioners are a mixed bag that ranges from total altruists to total mercenaries. Most people can learn a skill and incentivizing any skill via things like money or social status creates some goal-misalignment, but also dramatically increases the prevalence of the skill and also the community surrounding it, including research, pedagogy, and infrastructure. I think there's considerable value in not automatically trusting every medical practitioner, but on the whole many of them have earned credibility
Medical institutions have mostly been responsible for the existence of trustable practitioners and research, though in the rich world and especially the US specifically there are significant misalignments that come from capture from power-hungry parties in both government and the private sector. The American medical establishment in particular seems at this point near unsalvageable, having broken so badly that it often deliberately tanks quality of care to enforce state power or to turn a profit. We should probably rethink a lot of how institutions fund research, administer hospitals, prioritize care, act as financial buffers, what legal and enforcement authority we vest in medical practitioners sanctioned by the institutions, etc. So I agree with you there, especially in the United States specifically, though much of this was apparent well before 2025 (practically before I was born)
citation needed
I'm not even going to comment on this: "You're not a doctor, you're not qualified to tell the difference", because this is such a weird statement that I don't understand how anybody could utter it on this website.
If that is your standard for critical thinking, you are paving the way for anti-science rhetoric to dominate public discourse.
Treat people like stupid idiots if you want but then don't be surprised by the way they vote in elections as a result.
I won’t even get into the irony of you not realizing that not all forms of diabetes are related to insulin (diabetes insipidus) while simultaneously claiming that you don’t need to be a doctor to be qualified enough to make complex medical decisions.
In the first place, the analogy is wrong. You need insulin, you need blood sugar. Both SHOULD be present. Cancer never SHOULD be present, it just happens to be there often, like any other thing your body clears out.
Edit: the word “diabetes” originally comes from a word meaning “to pass through”. Literally the only thing linking all diabetic conditions is needing to pee a lot
They said detecting. Diagnosing is "hey, somethings wrong or odd, what is going on." Detecting is looking for something you otherwise may not ever notice. Not a doctor, just offering my definitions of two different words being used here.
If your reaction to something like this is an offhand "why don't you just...", or "experts don't matter", or "my grandma told me not to eat sugar because it feeds cancer", please, take a deep breath, and think twice before starting to argue with folks about this.
The research seems split on if it is worth it or just causes unneeded worry. Obviously if you catch something early then that is great, but there are a lot of people who have a ton of followup testing only to find out there is no issue.
There are also limitations with the level of detail a full body MRI can capture.
I could see it becoming similar to a colonoscopy where you get it like when you turn 30 or something and then every 5-10 years after that.
[1] https://jamanetwork.com/journals/jamainternalmedicine/articl...
Just look at this example of a gene regulation network: https://www.researchgate.net/figure/Different-visualizations...
You may also find this interesting:
"NRF2 activation is a predictor of poor clinical outcomes in lung cancer. Given the widespread use of NRF2-inducing compounds such as resveratrol and sulforaphane, these findings raise important concerns about their safety in individuals at risk for or living with cancer."
https://link.springer.com/article/10.1007/s11357-025-01736-0
Many people eat high-sulforaphane containing foods for health benefits.
And finally from last week https://newatlas.com/diet-nutrition/vitamin-c-air-pollution-...
This was about 1000mg / day for humans.
And that is the issue, I know 2 people who developed cancers when they were around 40, one died, the other person survived but had to be treated. So we close our eyes and hope for the best ?
These people under 50 were the first generation to sit around at home for long periods of time playing video games. The NES came out in 1985-86 in the US and home video gaming has been mass adopted since. From there add on the full adoption of sitting down at a computer for work in offices across the 1980s and 1990s. Then throw in the full adoption of home computing in the 1990s with Win3 & Win95 + GUI. And for the past 20 years, throw in the smartphone.
It's the sitting primarily, hours and hours of it every day.
...do you have a source for this causative link? It would seem like it's highly testable.