To Screen or Not to Screen, That is the Question


Xconomy San Francisco — 

Almost everyone knows someone who has had cancer. It is the disease that seems to strike the most fear in people’s hearts, in part because it seems to affect people so randomly. We all know that if we eat right, exercise and keep our cholesterol low we are less susceptible to heart disease, but cancer often doesn’t seem to care about such things as otherwise good health, which makes it especially worrisome.

In fact, cancer is the second leading cause of death in the United States. According to the American Cancer Society, about 562,340 Americans are expected to die of cancer this year, a number that equates to more than 1,500 people a day. Cancer is also among the costliest disease affecting our healthcare system. In 2009, the National Institutes of Health estimated the 2008 overall annual costs of cancer were as follows:

Total cost: $228.1 billion, comprised of:

  • Direct medical costs (total of all health expenditures): $93.2 billion
  • Indirect morbidity costs (cost of lost productivity due to illness): $18.8 billion
  • Indirect mortality costs (cost of lost productivity due to premature death): $116.1 billion

Because of the high prevalence of cancer and the high cost of treating it, early detection has become the mantra of many people within the healthcare system. An incredible amount of private and public scientific, medical, and financial effort and resources has been poured into the creation of early screening and diagnostic tools for various cancers with a focus on finding them at the earliest stages and in the least invasive manner possible.

A recent Reuters article discussed research currently underway to non-invasively screen for lung, breast, bowel, and prostate cancers through a simple breath test. This “electronic nose” uses sensors to pinpoint chemical variations in the breath. The research team found they could not only distinguish between healthy and malignant breath but also identify the four different common tumor types from a simple breath reading.

In fact, this model of using breath to detect cancer has been studied before, as the California-based Pine Street Foundation has done numerous studies demonstrating that dogs can effectively sniff out lung, breast, skin and prostate cancers. Perfect solution: miniature sensor-sized dogs-now there’s a nifty way for household pets to pay for their own upkeep and a truly untapped venture opportunity.

In any event, the idea behind early detection seems intuitive: when you find cancer early it’s said to be easier to treat more effectively and less expensive to treat overall. This is the argument that is used to compel insurers and employers to pay for cancer screening and early diagnostic tests, particularly since there is evidence that late stage cancers can be as much as 10 times more expensive to treat.

As with all things in life, however, nothing is black and white. There appears to be a point at which the utility of early cancer detection may be outweighed by the disadvantages of over-testing. According to physicians at UCSF, a renowned institution in the cancer field, some cancers are being found “too early.” In the above-mentioned Reuters article, UCSF’s representatives state that … Next Page »

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