Not a good idea. Unproven as a technique, very expensive, very low resolution when whole body imaging is performed, will miss important stuff, and generate unnecessary biopsy procedures.
Population screening is a vastly complicated area - for example, what would a whole body MRI be looking for. Name the process(s) and there will be a better way, even if its a scan of a smaller body site, the results will be vastly superior. Dedicated coils, established imaging protocols etc.
This is one of those things that seems like it would be a good idea but doesn't really work in practice. There are outfits where I live that will do a full body MRI for you for a few thousand bucks. So people think "Hey, what's more valuable than my health? Maybe I'll catch a tumor before it metastasizes and live an extra 20 years."
The problem is people have benign tumors and cists and other oddities that show up on the MRI, most of which will never cause a problem. And every time you have something done at the hospital, even something generally thought to be totally safe like a biopsy or a minor excision, there's some (hopefully very small) risk the doctor will make a mistake, or you'll react badly to anesthesia, or you'll pick up MRSA, or something else bad will happen unrelated to the reason you're there.
People have cranked the numbers on this, and what they found is you're more likely to die from an unnecessary medical procedure as a result of one of these scans than you are to be saved by early detection of a problem.
Exactly. And as I mentioned elsewhere in discussion, its hard to emphasize enough how low resolution full body imaging is compared to local area imaging. It's really bad. Slices of 7mm or so in thickness versus 3ish mm. Like all sorts of things, in imaging there is a relationship between the quality of the question and the quality of the answer. Have I got something wrong with me? Versus Have I got a HCC of the liver? One is more easily answered than the other.
Image fusion software exists that does this, allowing you to mere images and emphasis areas of difference (usually used for allowing comparison of different imaging modalities such as CT and PET, rather than same modality over time. The trouble is, people are never, ever in the same position (different breath hold, mobile organs move, people lie in different positions, get taller, shorter, more bent etc) , and, more importantly, are the changes seen problematic or normal?
In the case were a big mass has appeared, its easy. But that is easy to spot without software help. If a software technique is to emphasis small malignant changes early on, it's going to have to be very clever and be better than (or help improve the abilities of) some very clever people.
Edit: sorry, I do realize that this doesn't quite address what you said. Your suggestion would be very hard to implement I suspect, but is better than what I discussed.
Whole-body MRI? Several thousand dollars just for the scan. The radiologist's interpretation typically costs as much. We haven't even begun to talk about resultant interventions. Eat less and exercise more is a lot cheaper and more effective.
Where I work, about $700 US. It's not a great test, despite excellent radiologists and brand new equipment as whole body imaging is far lower resolution than localized imaging (its about 1500 pixels by 250 in resolution versus 512x512 when just your knee is done using an educated guess).
Based on the aggressiveness of the cancer in this story, my (non-medical) guess is that you wouldn't have seen the cancer any earlier unless you scanned every two months. This thing came out of nowhere and came fast.
Even if you did see it... what would you do? Surgery, chemotherapy, radiotherapy... these things don't stop a metastatic cancer this aggressive.
Without a cancer treatment that can stop the progression of an aggressive metastatic cancer within a week or two we are powerless to stop this type of death.
Affordable routine scans will result in massive overloading of the health system with unnecessary procedures, and the complications arising from those procedures will kill more people than would have died otherwise from whatever shows up on those scans.
There is no such thing as an intervention without risk, and that starts with the risks associated with general anaesthesia.
Scanning is one thing, interpreting a scan and deciding when and where to intervene is something that does not scale well at our current level of technology. Basically it needs a human to sit down and spend time analysing the scan to make sure that what is there warrants intervention. So even if the scan costs would drop to 0 you'd still have the component of the interpretation to deal with.
The end result of overloading the system like this is that those with symptoms that need care are less likely to receive it or receive it timely, and that those that didn't need the care will suffer from complications.
Knowing when to scan and when not to scan is a crucial ingredient in giving good care.
What if I get scanned every month and no one looks at them until I start showing symptoms?
My aunt got breast cancer recently. She got mammograms every year but the doctors never saw anything. Finally there was a mass discovered, and a when they went back to look at the old images, they could see it growing.
Better than what I said. And your last point flows into socializes versus privatized care quite quickly, where fear of litigation drives further testing, which creates a positive feedback loop.
The more you test for the more you need to test for.
In an exceptionally cynical view of private healthcare by S. Sheem, House of God, he says Rule 10: If you you don't take a temperature you can't find a fever.
There are quite a few gems in there for those with a dark sense of humour.
No. Many, many people have small, non-malignant cancers growing within us right now. Some people carrying such growths will develop life-threatening cancers, whilst the rest (probably the vast majority) of the population will die of something else at a ripe old age before the growths in question ever become malignant.
Once you start screening everyone, suddenly you have this huge population of growths that you have to biopsy in order to determine whether or not they're malignant or not. Your false-positive rate means that you start giving extremely harmful treatments (chemotherapy is itself mutagenic & can cause cancer!) to individuals who if they'd never have been scanned would have remained blissfully unaware of the harmless growth within them & would have had productive, happy lives.
Routine scans are not cost free: They put a huge diagnostic burden on the system & they inevitably mean that you deliver invasive, potentially harmful treatments to people that don't need them.
No, not now, maybe in the future (with regards to MRI). Even with breast imaging where MRI provides great results, routine screening is only shown to be helpful in those genetically predisposed to disease. Generating masses of biopsy procedures, untold stress, misdiagnoses, botched procedures etc. The false positive rate for MRI is currently too high in breast imaging for it to be a routine tool, let alone whole body imaging with the pitfalls in the technique.
I'm surprised there are three responses to this comment, all starting with the word "no". I'm not arguing for scanning irrespective of the cost. I'm saying that if the cost were 0 then you should always scan.
More information should always lead to better decisions and better outcomes. If it's the case that more information leads to worse decisions then it's indicative of a problem in your rule set, not a problem with your information.
Imagine if taking someone's blood pressure was a multi-thousand dollar test that required specialized expertise to interpret, and could easily lead to misdiagnoses of heart problems. Now imagine that we just got the technology to do it cheaply and easily. It wouldn't make anyway sense to be afraid of testing blood pressure- it's just more information that can lead to a more complete picture of a patient's condition. But that's exactly what my sibling comments are arguing for now with MRI scans.
The parent post wasn't some theoretical awesome scan with no false-positives; it was specifically whole-body MRI. Even if you could do a whole-body MRI scan for say a nickel, and have automated software mark all new tumors, more people would die sooner than if you hadn't done this.
Once you find a tumor you need to biopsy it before you can treat it. There is a small, but non-zero, chance of death from a biopsy. The number of tumors that won't kill you right away is so much greater than the number of tumors that will kill you right away, that this small chance of death multiplied by the large number of people with non-threatening tumors is a larger number than the small number of people with highly malignant tumors.
So then it's a problem with the rule set- you shouldn't automatically biopsy every tumor. It's doesn't make sense that there's a rule in place (you must biopsy every tumor) such that people are afraid of getting more information because it will lead them to make worse decisions. More information should always lead to better decisions and better outcomes. Why are we forced to biopsy every tumor, even in the case where you agree it's suboptimal?
Imagine if every time someone had really high blood pressure, we had a rule to perform bypass surgery. People would then avoid taking blood pressure because it might lead to surgery. That doesn't make sense- knowing someone's blood pressure isn't the problem, the problem is our suboptimal rule.
Ah, so now we uncover the real problem- our legal system. I have to admit that that's a real shame.
I hope cheap diagnostics become common place over the next twenty years so at least some countries can start taking advantage of more information to improve patient outcomes.
It's not a problem with the legal system, it's a problem with human nature. It is easier to blame someone for doing nothing, then to blame someone who does something and fails.
What is the cost-benefit ratio for a routine MRI scan every six months?