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The Epidemic of Fake Disease

Medlife Crisis7 HN recommenders · recommended in 7 months, 2020–2026
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explainer · general · evergreen · 2020–2026 on HN

A Medlife Crisis video by cardiologist Rohin Francis on overdiagnosis and over-screening. It explains how detecting more disease does not necessarily mean saving more lives, and covers harms such as unnecessary treatment.

Pointed to in threads about cancer screening, PSA tests, full-body MRIs and consumer diagnostics as an explanation of why more testing can hurt.

9 comments from Hacker News

@jamesbelchamber2026-02 · in “How often do full-body MRIs find cancer?”

It does, doesn't it! This is basically the reason scepticism in screening has risen (amongst scientists and medics, not the general population) - research seems to show that screening catches much more cancer but doesn't save many more people. Rohin Francis does a good video on it, which you don't have to watch because it has references underneath you can click straight through to (the video is good though): ▶ this video I am frustrated by this because it seems obvious to me that "more data == better" but I guess it makes sense if you think of the scans as having high amounts of noise, and us having a poor understanding of the system we're monitoring (this never happens in tech, of course :)).

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@fooblaster2022-09 · in “Shocking hospital mistakes led to our daughter’s death”

I'd encourage you to think about the consequences of over testing. Although it is somewhat counter intuitive, there are many negative consequences to patient outcomes from overtesting. A deeper overview: ▶ this video

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@eru2021-12 · in “The FDA's Restrictive Regulation of Home-Testing Devices (2017)”

Compare and contrast this video from 'Medlife Crisis': ▶ this video > Trying to detect disease early seems like an obviously good thing to do. But reality isn't always quite so straightforward, especially in medicine. If It Ducks Like A Quack is a series where I try to go beyond the hype and explore how complicated the apparently simple phenomena in medicine are. One point from the video: five year survival rates of prostate cancer in the US are massively better than in the UK. However, roughly the same proportion of people die of prostate cancer in both countries. The US just screens a lot more.

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@Someone12342021-11 · in “The paradox of the Prostate-Specific Antigen (PSA) test”

This video does a good job also of covering the topic of over-testing/over-treating potential cancer (or creating "Fake Disease" as it terms it): ▶ this video

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@ejolto2021-05 · in “Are we screening too much for skin cancer? It's complicated”

This one is even more relevant as he talks about dangers of over screening for beast cancer, and side effects of mastectomy+chemo: ▶ this video

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