Linda with Whiskers, Patches with me
1989
Somehow I got on the email list of Lancet, which is a British publisher of medical articles. Rarely a week goes by that I do not receive notice
of a new issue, containing many articles, some of which sound interesting. Unfortunately, Lancet is not in this game for love; they want $31.50 to read each
article, or about $200 for a yearly subscription. As the odds are strongly against me being
able to actually understand any given article, I do not bite. However, I have discovered a way to out-fox
them. It appears that most important
articles generate “Comments”, which I can read in their entirety, for
free! Thus, with a little imagination I
can reconstruct the article in question – or at least get a handle on its more
controversial parts. This I did for two
Comments on a paper dealing with the labeling of early pre-cancerous lesions.
As cancer doctors apply more and more early detection
techniques they find more and more things they call “lesions”, which may or may
not develop into cancer. The argument
seems to concern what to call them. If
you call them pre-cancerous lesions you scare the hell out of the patient, who
immediately insists on treatment - which costs money and entails greater or
lesser discomfort. If you call them
something else the patient doesn’t worry and unnecessary expense is
avoided. However, if one of these things
develops into cancer and the patient dies, all hell – in the form of
malpractice suits – may break loose. What
to do?
Well, they are arguing about that. In the meantime, notice what this dilemma
does to cancer statistics. If you label
a bunch of these lesion things “cancer” – when many of them aren’t – then it
appears that the survival rate for that particular cancer is high. And, of course, vice versa. Another reason
to be suspicious of cancer statistics.
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