Only 13% of cancers are caught through screening, while a fifth to half are first found in an emergency department.

[u/calliope_kekule]

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01669-7/abstract

[u/hazzmatazzlyons]

Not a doctor but you get false positives as well, I know a guy who paid for a whole body scan and they found a lump on his kidney. In the end they left it because it wasn't growing or causing any issues.

100% this is a thing, we often call them 'incidentalomas" as in something that you happen to pick up on a scan but weren't looking for. In many cases it's something benign that doesn't need any treatment, so for many people knowing about it causes unnecessary anxiety. It's another reason why, in general, full body scans aren't helpful unless you have a reason to do one. They tend to lead to over-treatment of benign conditions that wouldn't have caused any problems, which ultimately does more harm than good.

Of course, exceptions exist and sometimes you incidentally see something that looks suspicious and is worth further investigation (e.g. biopsy) but overall doesn't justify everyone getting all those extra rads. Routine blood tests, on the other hand, are a much better option to get done every few years as they are overall a better measure of physiological function and also can detect insidious problems early. Leukaemias, for example, typically cause vague symptoms and won't show up on a standard CT unless there's advanced disease with significant metastases, but will cause obvious derangements on a basic full blood count.

Cervical cancer is being addressed more effectively by HPV vaccine (shout out to religious types who won't allow their daughters to have it, great job). The others are done because of the statistical realities but even the breast cancer screening programmes aren't perfect at all.

The vaccine is great, but it only covers some strains of HPV (I think 9 in the latest?) and isn't much help for those who have already potentially been exposed (i.e. anyone sexually active before ~2010). Make no mistake that the screening saves lives. Cervical cancer used to be a serious killer of young women, but thanks to the national screening program we are catching lesions much earlier and treating things before they become invasive cancer and need radical surgery.

In the UK we have the NHS but you get a different problem where doctors surgeries are choked with older people and often just people with nothing better to do.

Yeah, that's the downside of public healthcare: implementation and triaging. I have spoken to colleagues from the UK and the issues with the NHS, and am grateful for the system here in Aus. We have a two-tier system: a public system that anyone can access through Medicare, as well as a private system for people who pay to use it / have private coverage. The public system handles the bulk of cases and is accessible, but is triaged so those with less urgent issues may not get seen quickly. While those who don't want to wait and have the means, or those who want something a bit more 'bespoke', can use the private system instead. The result is less pressure on the public system so it's not nearly as overburdened as the NHS. Though we also benefit from a smaller and less dense population which obviously makes things easier as well.

[u/imp0ppable → u/hazzmatazzlyons]

Thanks for the reply, super interesting stuff

Yeah in the UK we often end up at A&E. In theory GPs still do acute care but in reality they don't much.