Colonoscopies: a sure way to save thousands of lives every year.

Every year 50,000 Americans die of colon cancer or rectal cancer (combined, they are referred to as colorectal cancer). If Americans over 50 years of age (and those in other higher risk categories) were screened for colorectal cancer as recommended, 80% of these cancer deaths could be avoided. These numbers are staggering. To put them in perspective, about 3,000 Americans died during the 9/11 attacks, which caused this country to become apoplectic to the point where it started an entirely needless war that is currently in its seventh year. Needlessly undiagnosed colon cancer takes the lives of more than ten times as many Americans as 9/11 every year. Needlessly undiagnosed colon cancer killed enough Americans over the past twelve months to fill an entire major league baseball stadium. So where is the "war on colon cancer? My insurance company just send me a mailer reminding me of the importance of obtaining a colonoscopy, the gold standard for detecting and preventing colorectal cancer. The statistics are so stark that it would be irrational for anyone to not proceed with this procedure, even though going through with it are less than pleasant. Given that I'm 53 and I've never had such a procedure, I signed up. I started looking for information on the internet and found this highly informative video introduced by Katie Couric and featuring Dr. Jon LaPook, a gastroenterologist, who undergoes a colonoscopy on camera to demonstrate both the preparation and the procedure. After viewing this video, the entire thing looks a lot less daunting.
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God’s Ultimate Test

What if there IS a God? What if God is testing us? What if He is a cosmic prankster and has directed the creation of many differing religions to confuse us? What if God intentionally created the bible with its contradictions, inaccuracies, absurdities, mistakes, unbelievable occurrences and prejudices as a test? What if the test is to see if we fall for it? What if atheists are the ONLY ones going to heaven?

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Statistical illiteracy afflicts health care professionals and their patients

Over at Scientific American Mind Gerd Gigerenzer and his colleagues have published a terrific article documenting the statistical illiteracy that sometimes runs rampant in health care fields. The article, "Knowing Your Chances," appears in the April/May/June 2009 edition. The authors point out numerous medical care fallacies caused by statistical illiteracy , including Rudy Giuliani's 2007claim that because 82% of Americans survived prostate cancer, compared to only 44% in England, that he was lucky to be living in the United States and not in England. This sort of claim is based on Giuliani's failure to understand statistics. Yes, in the United States, men will be more quickly diagnosed as having prostate cancer (because many more of them are given PSA tests), and then many more of them will be treated. Despite the stark differences in survival rates (the percentage of patients who survive the cancer for a least five years, "mortality rates in the two countries are close to the same: about 26 prostate cancer deaths per 100,000 American men versus 27 per 100,000 in Britain. That fact suggests the PSA test

has needlessly flagged prostate cancer in many American men, resulting in a lot of unnecessary surgery and radiation treatment, which often leads to impotence or incontinence. Because of overdiagnosis and lead-time bias, changes in five-year survival rates have no reliable relation to changes in mortality when patterns of diagnoses differ. And yet many official agencies continue to talk about five-year survival rates.

Gigerenzer and his colleagues give a highly disturbing as example regarding mammogram results. Assume that a woman just received a positive test result (suggesting breast cancer) and asks her doctor "What are the chances that I have breast cancer?" In a dramatic study researchers asked 160 gynecologists taking a continuing education course to give their best estimate based upon the following facts:

A.) the probability that a woman has breast cancer (prevalence) is 1% B.) if a woman has breast cancer the probability that she tests positive (sensitivity) is 90% C) if a woman does not have breast cancer, the probability that she nonetheless tests positive (false-positive rate) is 9% The best answer can be quickly derived from the above three statements. Only about one out of 10 women who test positive actually has breast cancer. The other 9/10 have been falsely diagnosed. Only 21% of physicians picked the right answer. 60% of the gynecologists believed that there was either an 81% or 90% chance that a woman with a positive test result actually had cancer, suggesting that they routinely cause horrific and needless fear in their patients. What I found amazing is that you can quickly and easily determine that 10% is a correct answer based upon the above three statements--simply assume that there are 100 patients, that one of them (1%) actually has breast cancer and that nine of them (9%) test false positive. This is grade school mathematics: only about 10% of the women testing positive actually have breast cancer. As the article describes, false diagnosis and bad interpretations often combine (e.g., in the case of HIV tests) to result in suicides, needless treatment and immense disruption in the lives of the patients. The authors also discuss the (tiny) increased risk of blood clots caused by taking third-generation oral contraceptives. Because the news media and consumers so often exhibit innumeracy, this news about the risk was communicated in a way that caused great anxiety. People learned that the third-generation pill increased the risk of blood clots by "100%." The media should have pack is aged the risk in a more meaningful way: whereas one out of 7000 women who took the second-generation pill had a blood clot, this increased to two in 7000 women who took the new bill. The "absolute risk increase" should have been more clearly communicated. Check out the full article for additional reasons to be concerned about statistical illiteracy.

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Just how stupid are Americans?

About some things, Americans are incredibly stupid. For instance, I’ve kept an eye on science and religion related ignorance for years. 15% of Americans don’t know that the Earth revolves around the sun. Half of the people in the United States (an allegedly “Christian Nation”)  can’t name Genesis as the first book in the Bible.

There are a lot more statistics where those came from. If you’d like to read a few dozen zingers, read Rick Shenkman’s article in Alternet, “Ignorant America: Just How Stupid Are We?” There are some real head-shakers in Shenkman’s article. Several might have you wondering whether we should require citizens to pass rudimentary intelligence tests in order to vote. Shenkman’s compilation of stupidity had me wondering this. I know that this is an extremely controversial idea based on the way it has been misused in the past. It is clear, though that huge numbers of people have no idea how their government is designed to work, who is running their government, the basic characteristics of the scientific method, the basic facts of the religions to which they cling, or rudimentary principles of geography, history or economics. Now really . . . should such a person vote? This question makes me squirm.

I’m not really suggesting that we should take official government action to keep people from voting based on their intelligence levels. On the other hand, reading Shenkman’s article makes me wonder whether our “Get out the vote” campaigns should be focused on getting …

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