lead time bias
oracknows | April 10, 2017If you were to rely on much of what you see in the mainstream media and on social media, you probably have the impression that we are not doing very well against cancer. Indeed, a common trope I see in a lot of articles is that we are somehow "losing" the war on cancer. Just for yuks, I Googled the term "losing the war on cancer," and it didn't take long to find a lot of articles, both in the mainstream press and, more predictably, on alternative medicine-friendly websites making just that argument. Indeed, in 2011, which was the 40th anniversary of President Nixon's declaration of "war on…
oracknows | October 6, 2016A frequent topic of discussion on this blog is the concept of overdiagnosis. It’s a topic I’ve been writing about regularly since around 2007 or so and is defined as the detection in an asymptomatic person of disease that, if left alone, would never progress to endanger that person’s life or well-being within his or her lifetime. The problem with overdiagnosis is that it pretty much always leads to overtreatment, the treatment of overdiagnosed disease that is not health- or life-threatening. The key shortcoming in our knowledge that leads to overtreatment is that, once we detect disease with…
oracknows | October 21, 2015One of the things that feels the weirdest about having done the same job, having been in the same specialty, for a longer and longer time is that you frequently feel, as the late, great Yogi Berra would have put it, déjà vu all over again. This is particularly true in science and medicine, where the same issues come up again and again and again, often with the same arguments on either side. Sometimes the same players are even involved. So it is with mammography recommendations. Indeed, I'm feeling déjà vu all over again right now, as I read headlines like Women advised to get mammograms later…
oracknows | April 9, 2014As I write this, I am winging my way home from the 2014 meeting of the American Association for Cancer Research (AACR, Twitter hashtag #AACR14) in San Diego. (OK, I'm revising this to fit the format and, of course, the Insolence of this particular blog. Shockingly, I didn't have as much time to blog in San Diego as I had thought I would. Go figure.) Basically, the AACR meeting is one of the largest meetings of basic and translational cancer researchers in the world. I try to go every year, and pretty much have succeeded since around 1998 or 1999. As an "old-timer" who's attended at least a…