Cancer DNA is detectable in blood years before diagnosis

EDIT:

Adding these caveats:

1. There is a ton of nuance in the diagnosis, since most people have a small amount of cancer in their blood at all times

2. The screenings are 5-10k + follow up appointments to actually see if its real cancer

3. All in cost then could be much higher per person

4. These tests arent something that are currently produced to be used at mass scale

The usual story is that you’re just better off not knowing because you’ll end up doing more harm than good chasing every little suspicious diagnosis. Cancer happens all the time, but many times doesn’t lead to anything.

It's the same reason they pay for annual physicals in the first place.

This is not to downplay the potential benefit of early cancer detection... which is huge. And in the US/UK anyway, there are ongoing large trials to try to figure some of this stuff out in the space of blood-based cancer screening, as part of the path to convincing regulatory bodies and eventual reimbursement for certain tests. As mentioned, you can currently at least get the Galleri test out of pocket (<$1k, not cheap, but not exorbitant either), as well as whole body MRIs (a bit more expensive, ~$2-5k).

People talk about the “immune system” but they are really referring to a number of systems the body uses to regulate itself, more or less successfully, around environmental pressures. The body is a system under tension, sometimes extreme tension leads to extreme success (success here being growth of power), sometimes it breaks the body, and sometimes the systems have been slowly failing for a while, and most treatments will not help. Medicine is only useful in the specific case where the power of the body would be promoted if not for one thing, that the body would be healthy, at least manageably so, without that issue.

We do a lot of CT imaging in the emergency department and it sucks if we incidentally find an abnormal growth in a young patient's CT head. These are usually benign and often not worth performing brain surgery to get a biopsy.

Is it moral for a doctor to give a test they think is going to increase someone's chance of death.

Incorrect.

There are tons of cancers that hide and mask with symptoms common to other symptoms. Kidney cancer, for example, presents pretty similarly to both kidney stones and UTIs. Even blood in the urine isn't proof positive that anything is wrong beyond either of those conditions. And, by the time blood is in the urine, it's often too late.

Liver cancer is even worse. The first symptoms you get can be thought of as a simple pulled muscle, just a little ache in the back. By the time you have appreciable problems, like turning yellow, it's quite advanced and too late to really do much.

There are common cancers like colon, skin, breast, and prostate that more fit your description of being mostly harmless so long as you get regular screenings and eat healthy. But, for every part of the body, a cancer can form and the symptoms are very often invisible.

I'm unfortunately all too familiar with how cancer looks. My wife currently has stage 4 cancer that started as kidney cancer. She does not drink or smoke, gets enough rest, and is very active.

thanks for adding the caveats; they suggest that there are good reasons why it isn't clear cut that health care companies should pay.

Annual MRI?

I do wonder if a 5 year whole body MRI or CT would be generally beneficial for the population. I don't think it needs to be Annual to have benefits.

The problem is it really isn't uncommon for your body to create random puss fill sacks all over the place. It's one thing our cancer doctor warned us about. My wife is now on a 6 month CT regimen and ultimately, they'll just ignore new lumps.

Many prostate cancers, for instance, are slow growing and won't kill you before something else does. If you try to take that kind of cancer out surgically or zap it with radiation or chemo the side effects could be severe.

GP wasn't asking what they should personally do. They were asking how the doctor would screen for it. (The truth is, the doctor can't/won't-- an annual MRI on every otherwise healthy person, for example, would be prohibitively expensive with how MRIs are currently set up-- and as another commenter pointed out, findings from those can be just as easily ignored or put off until it's too late.)

Being beside that hypochondric point is statistically a much healthier place to be.

The current state of medicine is the current state of medicine in the actual world.

The internet is a powerful tool of communication, but turns out some people don't have anything worthwhile to communicate.

It involves costs of healthcare for all people involved, workload on health professionals, hospital occupancy, etc and so forth.

If the rate of false positives in these tests are too high, people that need treatment for their actual illnesses might be on a waiting list because too many are doing follow-up screening and biopsies for non-issues.

And to address your silly "collectivist" fear-mongering, your hyper-individualist mentality is a societal disease. We could do with some more collectivism, in the sense that people have a better understanding of the constraints and conditions of the society they are inserted in.

Thus, in young people cancer presents rapidly as they develop, these screenings are expensive and unnecessary. For old/sick/unhealthy people, or people who are predisposed to certain cancers, they will probably get something else anyway, so its an expensive workup to help treat a disease that won’t actually benefit much in the long term.

I’m not against treating cancer, however let’s recognize that cancer treatment is already an expensive and resource/labor intensive process. And 10yr survival rates are not great for most cancers, we’re only slowing the burn, not stopping it. Sometimes you get lucky and die of something else before the cancer can come back, but nobody is ever “cured,” they are all just delaying the inevitable. Which, as we have seen, can sometimes be worth it (who wouldn’t want another 10 years with a loved one?), but that doesn’t mean our goal should be to find a way to “cure” cancer, it should be to find a way to better manage it, and these screenings don’t seem like they really are, or at least the use-cases for them are minimal.