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Comment by the_monocle

7 days ago

In my dad’s case it very likely did - it was lung cancer and still pre-symptomatic, but had already started to metastasize, so a later discovery would probably have meant a much worse prognosis category.

I agree anecdotes don’t generalize and broad population screening sounds like a bad tradeoff. What I’m wondering about instead is risk-stratified situations: once someone already has elevated risk or prior lung disease and you’re imaging them periodically for legitimate reasons, incidental findings may carry much more signal than noise.

For example, people with prior tuberculosis often get periodic chest X-rays, not to screen the general population, but because their baseline risk is different. My dad had prior lung disease and existing imaging to compare against, which probably made the finding actionable rather than just another false positive.

So not “scan everyone”, more “the usefulness of incidental findings rises quickly once pre-test probability isn’t tiny”.