Early Detection of Cancer -The Good, the Bad, and the Ugly

Let’s think ahead. Where might this discussion lead? Is it just an intellectual exercise or can it leads to clinically useful results. My thought is that in a year or so we will have a number (hopefully large) of papers that discuss where and when early detection of cancer works well and where and when it does not work well. Perhaps this will lead to new ideas or at least properly document problems that need to be solved. Then perhaps some smart young scientists will be motivated to work on solutions to important real problems. There is a major need for such work. I will provide one “good” example of a screening process that when done properly is excellent but when done less than properly is far less valuable. The typical patient does not know if he or she got a good colonoscopy or a less than good colonoscopy. You have to know what question to ask and what acceptable answers are. It is not obvious.