The dark side of early diagnosis

A piece I wrote for Prospect Magazine in August 2018, about the uncertainties surrounding health screening. Read the full article here (It belongs to them after all).

What can add five years to your life without lengthening it by a single day, improve the performance of the NHS while wasting its resources, and make people grateful for unnecessary suffering?

The answer is early diagnosis.

Early diagnosis sounds like a no-brainer. The NHS has targets for speedy diagnosis and treatment of cancer, and offers screening for a wide range of conditions, in babies, children and adults. Private medicine and charities offer even more.

Much of this early diagnosis can, without doubt, be a very good thing. What’s surprising is that in the wrong hands or the wrong circumstances, it can also be a very bad one. To make matters more complicated, sometimes it can be hard to tell the good early diagnosis from the bad. The story of our attempts to put the logic of early diagnosis into practice is a hard lesson in the human costs of failing to communicate that uncertainty, and the dangers that lurk in the intuitively obvious …