The Hidden Problems of Early Cancer Detection
Cancer experts are increasingly arguing that the benefits of early detection are often overstated and its harms underplayed
On October 23, tech investor Andrew Wilkinson tweeted an MRI image of a cross-section of his body, including his lungs, spinal column, and musculature. The picture’s caption name-checked Prenuvo, a Vancouver-based diagnostic clinic offering scans like his at prices ranging between approximately $760 and $1,900.
“Wild numbers,” he wrote. “Out of 1,000 people scanned, 44 will have cancer, often in a treatable stage. Worth doing.”
The fury of public health Twitter was swift and unsparing. “Terrible idea,” “ridiculously unethical,” and “wildly irresponsible,” wrote respondents identifying themselves as doctors. “The ratio of tech bros commenting about how this is brilliant, amazing, or the ‘wave of the future’ versus the actual physicians commenting on how there are serious and concerning potential downstream consequences to such over testing, over diagnosis, and over treatment is wild,” tweeted Dr. Taylor Nichols, who identifies himself as an emergency medicine physician.
Reached by phone a few weeks later, Andrew Lacy, Prenuvo’s CEO, was magnanimous in his assessment of how his company’s MRI screenings fit into the larger field of longevity therapies: “Somewhere amongst all of these different interventions there are, for sure, some things that actually will make you live longer,” he said. “I trust the patient to make an informed decision about what to do with their own health.”
The idea that early disease detection is a net good for human health is baked into every level of medical practice. The concept is integrated throughout medical education and is an assumption underpinning preventive health recommendations, research funding, diagnostics research and development, and the marketing of mammography and endoscopy centers.
While early diagnosis is key to living longer and better with certain conditions, cancer epidemiologists are increasingly arguing that its benefits are often overstated and its harms underplayed, especially when it comes to cancer. “Our ability to detect abnormality is increasing dramatically,” says…