Sensible Medicine This Fortnight in Medicine (Episode II)
Jun 18, 2025
The discussion kicks off with a look at the latest advancements in a new COVID vaccine and its impact on public trust. A groundbreaking blood test for colorectal cancer screening is explored, weighing its benefits against traditional methods. Challenges in cancer screening reveal the delicate balance between detection and accuracy. Sepsis diagnosis complexities are highlighted, critiquing the one-size-fits-all approach of current treatment bundles. Lastly, financial incentives in cardiology raise questions about aligning healthcare costs with patient outcomes.
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Challenges in Colon Cancer Screening
- Colon cancer screening is important but current methods like colonoscopy have limitations.
- A blood test detecting tumor DNA aims to improve screening but faces challenges with sensitivity and specificity.
Limitations of Circulating Tumor DNA Tests
- Circulating tumor DNA tests like GRAIL aim to detect cancer early by identifying tumor DNA in blood.
- These tests struggle because DNA typically becomes detectable only when cancer has advanced.
False Positives Challenge Screening Tests
- Even with 79% sensitivity and 91% specificity, screening tests may cause many false positives in a low-prevalence population.
- This leads to many unnecessary follow-up colonoscopies and anxiety for people without cancer.
