Comment by danw1979
7 days ago
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.
But who will pay for the hundreds of thousands of screening MRIs, along with the large number of incidental results that will require some sort of follow-up? Many patients will seek second opinions if not recommended to "cut it out", with additional costs also for the complications resulting from unnecessary biopsies. US medical care is already tremendously expensive; adding all of these costs will break the bank and for no real benefit.
> 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.
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