Are you implying that more active screening would cause more good than harm, and that the scientific evidence that shows otherwise is mistaken? What makes you think the evidence is wrong?
Or do you simply not support using scientific evidence and/or harm reduction to guide medical policy? What do you propose should be used instead in that case?
There is no problem with screening literally all the time, provided that the goal of screening isn't to immediately trigger a response from a single sample, but rather just to gather time-series sample points which can later be fed into predictive models to trigger alerting. (Where those "predictive models" can just be, y'know, your GP's eyes at your yearly checkup, as they flip through a series of your CT scans as a little flip-book.)
> There is no problem with screening literally all the time,
I have no opinion on the matter but this is disputed for some screening methods, which supposedly can increase the the risk with statistical significance. I don't believe that they ever nailed down the cause though, but I'm not a medical professional so I am not really well read on the topic.
Yes, but that's not a problem with screening as a concept, that's a problem with those screening methods. We accept "destructive testing" in medical screening (e.g. biopsies; x-ray fluroscopy with both radiation and carcinogenic chemical tracers; etc.) because we haven't structured medical screening in such a way as to incentivize investment into "non-destructive testing."
The medical establishment doesn't care about the potential for harm from repeated use of methods on patients†, precisely because we think of them as things that only need to be done rarely. There's been no need to optimize for "low cumulative impact" in screening methods, because there's currently no incentive to do screening often enough for it to matter.
Let me put it this way: the state of the art in MRI technology (reducing required size + cost per machine to enable more frequent + "trivial" use) is being pushed forward economically almost entirely by demand from Operations Research in the aerospace industry, rather than by demand from hospitals wanting to have more MRI-machine capacity per patient. That's ridiculous.
† The freshest example of this on my own mind isn't diagnostic per se. Have you ever noticed that dentists don't tell you to close your eyes — nor give you UV-blocking wraparound goggles — despite shining a UV light directly at your face for 30 seconds at a time to harden UV bonding resin they've used? They know it'll hurt their eyes if they stare at it all day — which is why the UV lights they use have circles of UV-blocking backscatter guards, to allow them to look at your face without reflected UV light hitting their eyes. But there's no concern for what they're doing to you, because you're only getting a few cumulative minutes of concentrated dental UV per year, vs. their cumulative hours of exposure.
A cost-benefit analysis can have different answers when applied to an individual vs. a population. That something is rare isn’t much comfort when you’re the one in a million rarity.
I think the point is that not all cases are cut and dry. There are many for which evidence is inconclusive; and for those having a blanket regulation is worse than letting the patient and the doctor select a choice that the patient prefers.
Then they chose a poor example to illustrate their point, since anyone is free to book a cancer screening even if they are younger than the recommended age, if they so prefer.
You can try and book anything you like, but the doctor/technologist is under no obligation to actually run the screening test for you, and if they do there is not requirement that your insurance pay for it. So you can have a full body MRI reference done, but it will cost many k$ out of pocket, if you can get someone to do it for you.
Your video seems good and I don't know if he is an authority but his description he makes clear that he is not an authority.. but it's about asymptomatic screening, while my point was about continuous symptom minimization and mischaracterization.
There are also some obvious mistakes in his overessentialization of the statistics, which imply that early detection never results in a nonfatal prognosis.
Screening is a very complicated topic and being overly aggressive with screening can really hurt patients. https://www.youtube.com/watch?v=yNzQ_sLGIuA
Or do you simply not support using scientific evidence and/or harm reduction to guide medical policy? What do you propose should be used instead in that case?