Research Translation Podcast

The Myth of Early Detection


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Imagine a weatherman who’s wrong 97% of the time he predicts rain. Picnics and ballgames canceled, flights rerouted, bikes garaged. Yet somehow, he has fans—devout ones—who revel in warning their neighbors about coming storms.

“Stock up!” they cry, taping their windows.

“Oh my! Thank you!” the neighbors reply.

Worse, this weatherman also misses a third of real storms, sending his fans to the beach just as the cats and dogs start flying.

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You’d think such a record would end a career, not build a following. But imagine a town so terrified of rain that its citizens watch every forecast like scripture. When the skies stay clear, they’re not angry—they’re grateful. The weatherman’s vigilance, they believe, is a gift. Surely, one day, he’ll save their life.

That town is the Western world. And cancer screening doctors are the weathermen.

For decades, we’ve treated ‘early detection’ as gospel. Professional societies and public-health agencies extol it as lifesaving—despite the data. No cancer screening test has ever been proven to save lives, and virtually all are about as accurate as our hapless weatherman.

The damage is not theoretical. Neuroblastoma screening in Japan, Germany, and Canada was abandoned after trials showed it harmed—sometimes killed—more children than it could ever save. Thyroid screening in Korea was halted when it led to a flood of false cancers and needless surgeries, with no drop in mortality. Even mammography, the most studied test in history, generates millions of extra lumpectomies and mastectomies, without extending women’s lives.

People can still choose screening, of course, if they understand the trade-offs. The problem is, they rarely do. And it’s about to get worse.

Headlines are now celebrating a new ‘multi-cancer early detection’ blood test. Funded and run by the manufacturer, the PATHFINDER-2 study is being trumpeted in press releases and medical conferences. Early detection, but earlier! Detect-ier!

Incredibly, the researchers don’t even pretend their new test can save lives or help people. Instead they parade the test’s ability to detect more, and earlier. With any knowledge of the history of early detection, this is a breathtaking deceit.

And it’s worse than it sounds, because the test missed 60% of the cancers it tested for. The reason most people submit to screening (with or without knowing the dangers) is their belief the test can catch cancers—it is the raison d’être for cancer screening. But the new test is WORSE.

These numbers make it worth asking: Did screening ever make sense? Does anyone truly believe, for instance, that detecting a lump on a mammogram instead of under a fingertip is the difference between life and death? For those who do, consider the findings from more than 600,000 women in randomized trials: It isn’t.

And yet, there is good news: Evolution beat us to it. The immune system runs a nonstop, exquisitely precise screening program, detecting and destroying mutated cells before they ever become disease. Immuno-surveillance, as it is known, is everything human technology isn’t—sensitive, specific, safe, and free.

So be skeptical of the next miracle in ‘early detection’. The best screening technology ever invented is already inside you. And unlike its commercial counterparts, it doesn’t sell false alarms.



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Research Translation PodcastBy David Newman