Cancer is one of the leading causes of death worldwide. Millions of dollars are spent on cancer research every year, attempting to find new methods of treatment – but there can never be a true “cure” for cancer. Cancer comes in too many different varieties, and cancer cells are too closely related to healthy cells, for there to ever be a singule remedy for the disease.
The best tool we have is early detection – identifying and treating cancer before it begins to grow and spread out of control. Early detection can greatly increase the chances of successful treatment, so screenings and detection tests are common, especially for at-risk populations.
However, there are still some significant problems with modern detection methods that need to be addressed if we’re going to keep making progress.
South Korea has seen a 15-fold increase in the number of thyroid cancer diagnoses in the past 20 years. This is due mostly to new technology and medicine. Highly sophisticated machines and processes can detect cancer more easily than ever, and free cancer screenings are given to the majority of the population.
But here’s the twist: Despite the massive increase in early cancer diagnoses, the mortality rate for thyroid cancer has remained about the same. Thousands of people are having their thyroid glands removed and forced to take hormone replacement drugs for the rest of their lives, and possibly for no reason. This phenomenon isn’t exclusive to South Korea, either; in the United States, the number of total cancer diagnoses has tripled since 1975, but the mortality rate hasn’t declined much at all.
The problem here is overdetection. It’s good, in many cases, to catch cancer in its earliest stages of development, but if the cancer isn’t the type to spread, or if the diagnosis is false, it could force a patient to undergo unneeded treatment.
Current cancer screenings are often uncomfortable. In a typical mammogram, for example, patients are forced to disrobe and undergo mechanical breast compression, which is sometimes uncomfortable to the point of pain. It takes two to three weeks to get the results – at which point even more imaging may be required. The amount of discomfort here is not only psychologically harmful, it also dissuades patients from getting the screenings they may need.
There are thousands of different types of cancer, since all cancers are mutations of otherwise healthy cells, so it’s tough to predict exactly how cancer in one person may behave. Regardless, doctors tend to assume all cancers are going to be aggressive, spreading or growing worse at a rapid pace. This mentality is dangerous, because it contributes to the overdetection problem, often leading doctors to recommend strategies effective against aggressive cancers for cancers that are not aggressive. In many cases, patients do not receive the “ideal” treatment for their specific disease.
4. Cost efficiency
Some critics have also pointed out that the rapid improvements in technology and research aren’t worth the resources we’re pouring into them. New screening and detection methods often cost millions of dollars to develop, and thousands of dollars to patients using them – all for only a negligible decrease in patient mortality rates. The money and effort spent here could, instead, be used to research and understand better the different types of cancer and how they develop, or for cancer prevention efforts to promote healthy lifestyle changes that prevent cancer from forming in the first place.
Fortunately, many cancer researchers and physicians understand these problems. In some ways, overdetection is better than underdetection, and discomfort is a small price to pay for an effective screening. Still, any improvements we can make in this area have the potential to save lives, save money, and improve individuals’ health, so it’s our responsibility to keep pushing for more progress.