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The major reason not to do this is that you often get worse outcomes for patients. Oncology provides a lot of examples where “more knowledge” does not lead to better outcomes. Routine ovarian cancer screening, prostate screens, childhood neuronlastoma screens, and breast cancer screens all have shown that overuse will identify more cancer, but do not lead to better outcomes like reduced mortality.

The reasons are complex, but the short answer is that cancer treatment is extremely hard on your body, and even if you don’t treat, stress can literally make you sick. I recommend reading The Emperor of all Maladies if you want to really get a sense for how delicate the problem of early screening is.

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I’m married to someone running various prostate cancer studies in the UK. I hear the arguments against screening a lot and the issue really blew up recently in the news here.

The thing is, when researchers talk about “worse outcomes” they’re often comparing survival (or rather lack of) against terrible side-effects.

What this fails entirely to capture is that doing something to increase your odds of survival, damn the consequences, is an individual choice. It shouldn’t be up to a health economist to make that judgement.


> What this fails entirely to capture is that doing something to increase your odds of survival, damn the consequences, is an individual choice.

What you're failing to capture is that this is a hard problem because it's both an individual choice and a collective one as well. Those "terrible side effects" might actually end up killing someone. You're choosing between a high-chance lottery on a small population or a low chance lottery on a far larger one. It's not that simple.


Every choice carries a ripple. Survival isn’t just personal, it’s strategic. Operatives plan knowing their move can save or cost more than just themselves.

Population level policy optimizes averages. Individuals optimize their own risk tolerance.

The real lesson is this. Never outsource life changing decisions to systems built for efficiency. Think independently. Act intentionally. Build that mindset at foundniche.


I appreciate that, but do wonder, if this is an issue with too much data or how we act on that data. In other words, could there be a future where we do have tons more data, but also use the data in such a way to achieve an overall better outcome for patients?

Ultimately its a balancing act between what we can know and what we can do about it. If you can’t treat a cancer (or your treatment is not effective, cf the radical mastectomy) then knowing who has it doesn’t help. As technology progresses and more cancers become readily treatable, it will make more sense to do early screening, and potentially full body MRIs.

But right now it is likely to cause a huge waste of time, resources, and yes, human lives to know about every little lump in your body.


Knowing every lump won’t save lives if you don’t act effectively on it. Focus on building tools and treatments that actually move the needle, not busywork that wastes time and resources.

Maybe, but there's a human element that can make things worse too. Take prostate cancer as an example. Most men die with prostate cancer. Most men don't die _from_ prostate cancer. It isn't usually aggressive enough to matter. Most people aren't zen enough to accept that though, so just knowing that you have cancer can add stress to your life with measurably bad health impacts from the resulting hormonal changes (reduced immune function, impaired sleep, increased clotting tendency, slower wound healing, etc).

More data is not always better decisions. Precision beats paranoia.

Same rule in business. Chasing every signal kills performance. Focus on what actually improves outcomes. Build smarter with foundniche.


Then they should decide not to treat certain things and have better criteria around that than choosing to bury their heads in the sand and letting people die out of their ignorance.



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