WEBVTT - What are false positives? 0:00:01.120 --> 0:00:04.560 Welcome to stuff you should know from how Stuff Works 0:00:04.600 --> 0:00:14.200 dot com. Hey, and welcome to the podcast. I'm Josh Clark, 0:00:14.280 --> 0:00:18.400 and there's Charles W. Chuck Bryant. It's just us. There's 0:00:18.440 --> 0:00:22.479 no producer, there's no guest producer, there's no nothing, just 0:00:22.560 --> 0:00:25.400 a ghost in the chair. Why is it whenever we're 0:00:25.400 --> 0:00:27.400 in this room, just the two of us, I go 0:00:27.520 --> 0:00:30.840 back to like elementary school or middle school and feel 0:00:30.880 --> 0:00:35.760 like we should just start drinking whiskey or something. Isn't 0:00:35.760 --> 0:00:40.600 that weird? Uh? Yeah, well, I guess Jerry kind of 0:00:40.640 --> 0:00:44.160 provides like a teacher like presence, and I guess Nol 0:00:44.320 --> 0:00:46.919 is kind of like a substitute teacher like presidents. So 0:00:47.479 --> 0:00:49.760 I didn't ever have the urge to drink whiskey in 0:00:49.840 --> 0:00:52.879 elementary school. But I can see where you're coming from. 0:00:52.920 --> 0:00:55.320 It was eighth grade before that started from me. I 0:00:55.360 --> 0:00:57.320 did drink to college. But I don't know. It's just 0:00:58.280 --> 0:01:00.760 and neither one of the Jerry. No one would care. 0:01:00.840 --> 0:01:03.640 Even it's just some weird thing about the teacher leaving 0:01:03.640 --> 0:01:07.119 the room. After all these years, I'm still like, all right, 0:01:07.200 --> 0:01:10.520 I need to act up right. My thing went more 0:01:10.560 --> 0:01:14.000 towards paper airplanes than breaking out the pint bottle whiskey 0:01:14.040 --> 0:01:18.679 I have in my sock. Again, I didn't even drink 0:01:18.760 --> 0:01:20.480 until college, so of course I wasn't doing that. I 0:01:20.560 --> 0:01:23.640 just probably started joking around. No, I know what you mean, 0:01:23.720 --> 0:01:28.880 but today's Chuck, but hit the bottle right. Actually, today's 0:01:28.959 --> 0:01:31.920 Chuck is all business. Because I hate to tell you this, buddy, 0:01:32.040 --> 0:01:35.920 but you're doing your job right now. That's true. We 0:01:36.040 --> 0:01:39.360 both are because this is our job to podcast. It's 0:01:39.360 --> 0:01:43.560 funny during the the Emily and Chuck pre Oscar's Mini 0:01:43.560 --> 0:01:45.880 Crush show, it was kind of dragging on. She's like, 0:01:45.920 --> 0:01:48.160 this starting to feel like a job, and I was like, 0:01:48.400 --> 0:01:52.559 this is my job. This is the job. The job 0:01:52.640 --> 0:01:54.720 we we say. We talked about it like cops talk 0:01:54.760 --> 0:02:00.280 about their jobs, good jobs. We're real, real podcasters that job. 0:02:00.960 --> 0:02:03.040 Remember that show The Wire. Have you ever heard of it? 0:02:04.080 --> 0:02:07.360 I'm just kidding. We've talked about it before. I remember 0:02:07.600 --> 0:02:12.000 they called that one uh cop, real police, Yeah, real police. 0:02:12.160 --> 0:02:15.520 I can't remember her name. Yeah, they said a lot 0:02:15.560 --> 0:02:18.680 on that show. Yeah, but they mostly talked about one 0:02:18.960 --> 0:02:24.520 officer in particular, police trying to think of Yeah, right, 0:02:25.400 --> 0:02:30.520 there you go, So let's start real podcasting is this 0:02:30.560 --> 0:02:33.959 one gonna be a stinker. No, it's not. Actually, it's 0:02:34.080 --> 0:02:38.160 actually really do you know why, because it has the 0:02:38.200 --> 0:02:41.440 hallmarks of a good episode, And I'm gonna I'm gonna 0:02:41.480 --> 0:02:43.639 peel the curtain back a little bit for everybody, Chuck. 0:02:44.840 --> 0:02:47.320 One of the hallmarks of a good episode, at least 0:02:47.360 --> 0:02:52.239 of stuff you should know, is that there is controversy 0:02:52.400 --> 0:02:55.200 associated with something even where there doesn't seem to be, 0:02:56.440 --> 0:03:00.200 and that there are people who are either getting drew 0:03:00.240 --> 0:03:05.680 it over, suffering, being neglected, being abused. There is some 0:03:05.880 --> 0:03:08.960 group of people who the rest of the world aren't 0:03:08.960 --> 0:03:12.360 really thinking of, um, who are who are suffering at 0:03:12.360 --> 0:03:15.400 the hands of other people. And this this actually, this 0:03:15.440 --> 0:03:19.640 episode has all that, all right, Surprisingly, I'll let you 0:03:19.680 --> 0:03:24.600 guys guess where that stuff comes in. Alright, So we're 0:03:24.600 --> 0:03:30.360 talking about false positives, and here's what that is. If 0:03:30.360 --> 0:03:33.120 you've ever been to the doctor, I've had a medical 0:03:33.160 --> 0:03:39.480 test done generally, well, not generally always, you will get 0:03:39.520 --> 0:03:43.040 one of four results. Yeah, good point. You can get 0:03:43.040 --> 0:03:45.960 a true positive. And remember, when you're getting a medical 0:03:45.960 --> 0:03:50.760 test back, positive is negative. Yeah, usually means bad news. 0:03:51.000 --> 0:03:53.280 Positive is not good. They don't say I have news, 0:03:53.760 --> 0:03:56.400 I have good news. For you. Your results are positive, 0:03:57.680 --> 0:03:59.600 it's a little bit of a mind trick that you 0:03:59.640 --> 0:04:04.920 need to reform. But positive is you have this condition. Right. 0:04:05.000 --> 0:04:09.640 It means that the the test that that searches for 0:04:09.840 --> 0:04:14.880 a condition found a result. It is confirmed as yes. Right, 0:04:14.960 --> 0:04:18.159 so that's it should say that's a true positive. Right. Yeah, 0:04:18.160 --> 0:04:20.280 then you've got a true negative, which means you don't 0:04:20.320 --> 0:04:24.039 have this. However, I feel like me or probably you 0:04:24.120 --> 0:04:27.479 and most people, you say that's good news, but I 0:04:27.560 --> 0:04:30.040 should like to get a confirmation on that. Yeah, how 0:04:30.040 --> 0:04:32.640 do you know? How do you know? Doc? Then you 0:04:32.640 --> 0:04:34.479 can get a false positive, which is what we're talking 0:04:34.480 --> 0:04:38.000 about here, which is they say you have this condition, 0:04:38.080 --> 0:04:40.400 like let's say you have cancer. I'm sorry to tell you, 0:04:40.640 --> 0:04:43.159 but you don't, as it turns out later on, which 0:04:43.200 --> 0:04:46.919 is great. False positives are kind of they should call 0:04:46.960 --> 0:04:50.640 it the new lease on life result, right, the Dabney 0:04:50.640 --> 0:04:53.159 Coleman out of time result. And then the worst of 0:04:53.200 --> 0:04:57.919 all probably is the negative. Agreed. Man, I'm glad you 0:04:57.960 --> 0:05:00.800 said that, because this this article just walks right past 0:05:00.839 --> 0:05:05.120 that fact. That means results say you're fine, but it 0:05:05.120 --> 0:05:09.880 turns out that you're not. Your your toast, so whatever 0:05:09.960 --> 0:05:12.640 the lead and not even good avocado toast. You're bad 0:05:12.680 --> 0:05:16.880 burnt toast right, exactly terrible stuff with that really cheap 0:05:16.920 --> 0:05:20.200 sliced cheese that nobody would want to eat. What's what's 0:05:20.240 --> 0:05:24.120 the opposite of a lease on life to result um 0:05:24.160 --> 0:05:28.640 early death? Sudden early death out of the blue, Although 0:05:28.680 --> 0:05:30.839 there is something to be said about that, about just 0:05:30.920 --> 0:05:34.200 not knowing right just out of nowhere, bay up, you 0:05:34.400 --> 0:05:37.800 just fall over dead. That's not necessarily the worst way 0:05:37.839 --> 0:05:39.839 to go. Yeah, I guess I was thinking more in 0:05:39.880 --> 0:05:43.440 the play on words of instead of a new lease 0:05:43.480 --> 0:05:46.960 on life, something to do with renting in your landlord, 0:05:47.320 --> 0:05:53.039 so an old and uh, we'll figure this one later 0:05:53.279 --> 0:05:55.440 and dub it in Wait, what's it called when you 0:05:55.440 --> 0:06:01.239 get kicked out of your apartment? An old eviction death? God, 0:06:02.440 --> 0:06:06.320 we did it, chuck man. So those are if you 0:06:06.400 --> 0:06:08.360 take a test at the doctor, those are the four 0:06:08.440 --> 0:06:12.440 possible results you can get. What's really interesting here, and 0:06:12.480 --> 0:06:14.600 this is something that you're going to want to remember. 0:06:14.720 --> 0:06:16.520 And after you hear the rest of what we have 0:06:16.640 --> 0:06:19.279 to say, you're really gonna want to remember this. But 0:06:19.440 --> 0:06:22.400 when you hear something like this test that I'm about 0:06:22.440 --> 0:06:26.520 to give you is accurate It doesn't mean that if 0:06:26.520 --> 0:06:29.320 it comes back with a positive result that says you 0:06:29.400 --> 0:06:32.480 have this thing. It doesn't mean there's a nine chance 0:06:32.560 --> 0:06:35.480 that you have that. It just means that when they 0:06:35.480 --> 0:06:39.320 say a test is accurate, that if if you do 0:06:39.520 --> 0:06:44.560 have that disease, there's a chance that this test will 0:06:44.600 --> 0:06:50.200 catch it. Okay, huge, huge difference between those two things. Okay, 0:06:50.600 --> 0:06:53.760 that's step one. So really what this is saying is 0:06:53.800 --> 0:06:57.440 that this test doesn't let very many false negatives get through. 0:06:58.200 --> 0:07:00.000 And if you look at the numbers, this is how 0:07:00.040 --> 0:07:03.039 that works out. If you have ten thousand people chuck, 0:07:04.279 --> 0:07:09.960 and they take a test that's accurate. Uh and and 0:07:10.000 --> 0:07:13.600 this is so ten thousand people and the them don't 0:07:13.640 --> 0:07:16.119 have this and it's a ninety nine percent accurate test, 0:07:16.720 --> 0:07:20.680 there's going to be one hundred that come back positive 0:07:21.120 --> 0:07:26.840 out of ten thousand. Okay, nine of those positive results 0:07:27.000 --> 0:07:30.560 are going to be true. One is going to be 0:07:31.080 --> 0:07:36.720 a false negative. Okay, Okay, are going to be negative. 0:07:36.840 --> 0:07:40.880 They're gonna come back negative. One are going to be 0:07:40.920 --> 0:07:46.280 true negatives, but are going to actually be false positives. Right. 0:07:47.120 --> 0:07:48.840 I know this is really mind bending, but if you 0:07:49.040 --> 0:07:51.320 if you take the numbers like this, that means that 0:07:51.560 --> 0:07:55.200 only one out of nine thousand, eight hundred and two 0:07:55.240 --> 0:07:58.640 people had a false negative. So that's a big deal. 0:07:58.880 --> 0:08:01.040 As you said, that's the big daddy, that's the one 0:08:01.040 --> 0:08:04.680 you've got to really watch out for. But nine out 0:08:04.680 --> 0:08:09.760 of a hundred are false positives, which means that this 0:08:10.800 --> 0:08:14.560 accurate test has a fifty percent chance of giving you 0:08:14.600 --> 0:08:20.040 a false positive if you come back positive. Should I 0:08:20.120 --> 0:08:22.200 just not even have said any of that stuff now? 0:08:22.280 --> 0:08:25.440 I think it's just funny that after ten years it's 0:08:25.520 --> 0:08:27.960 done on me that you have to true talents. One 0:08:28.080 --> 0:08:32.800 is explaining extremely complex things in a very easily digestible way, 0:08:33.800 --> 0:08:37.680 and the other is completely confusing me with words that 0:08:37.720 --> 0:08:40.480 come out. Well, this is very confusing stuff. I mean, 0:08:40.520 --> 0:08:43.360 it's not just me, this is BAYSI and statistics. Basically, 0:08:44.240 --> 0:08:46.920 the point of all of this is is that, first 0:08:46.960 --> 0:08:50.480 of all, if you're accurate test comes back that says 0:08:50.480 --> 0:08:52.320 you have something, it doesn't mean you have a ninety 0:08:52.360 --> 0:08:55.520 nine chance of that you have it. Very important number one. 0:08:55.840 --> 0:08:58.440 Number two, if it does say you have it, there's 0:08:58.440 --> 0:09:02.080 a fifty chance that a test is wrong even if 0:09:02.080 --> 0:09:07.400 it's accurate test. That's a big thing to remember that 0:09:07.520 --> 0:09:10.719 if your doctor doesn't explain that to you, you punch him, 0:09:11.000 --> 0:09:13.079 him or her in the arm and you say you're 0:09:13.120 --> 0:09:17.080 not doing your job fully because I'm scared, buddy. Yeah, 0:09:17.080 --> 0:09:19.400 I just got a positive test result and I'm scared 0:09:19.440 --> 0:09:22.000 out of my mind. So if your doctor is not 0:09:22.040 --> 0:09:24.920 going to come for you, hopefully Baysian statistics, well, and 0:09:25.000 --> 0:09:27.520 don't listen to me, go look it up yourself, because 0:09:27.600 --> 0:09:29.960 I'm sure someone else on the internet can explain it 0:09:30.000 --> 0:09:36.360 better than I can. Perhaps Mr Billy Bays in his 0:09:36.720 --> 0:09:40.240 whole statistical model. Was he a character of Melrose Place? 0:09:40.440 --> 0:09:44.600 I think so. He's a pool cleaner? Um. Alright, So 0:09:45.320 --> 0:09:48.320 with medical testing period, like you said, if your doctor 0:09:48.400 --> 0:09:50.439 is not telling me that, with with any test that 0:09:50.480 --> 0:09:53.760 you take, not all medical tests are created equally. Some 0:09:53.840 --> 0:09:57.960 are really accurate, some aren't as accurate as a well 0:09:58.000 --> 0:10:00.160 that's about say, so they could be. There's accurate as 0:10:00.200 --> 0:10:02.480 they can be, which is to say, maybe not as 0:10:02.480 --> 0:10:04.800 accurate as you would like it to be sure, but 0:10:05.160 --> 0:10:07.200 you really need to talk to your doctor and hopefully 0:10:07.240 --> 0:10:10.959 they're offering this up anyway, like, Hey, what's the deal 0:10:10.960 --> 0:10:13.600 with this test? How reliable is this? Do I need 0:10:13.640 --> 0:10:17.600 to get a second test? Because the whole thing with 0:10:17.640 --> 0:10:21.040 false positives and false negatives and even true positives and 0:10:21.080 --> 0:10:26.360 negatives is there's a bunch of different reasons why uh 0:10:26.400 --> 0:10:31.040 follow up testing is both good and bad. Like sometimes 0:10:31.040 --> 0:10:34.040 these procedures, like the follow up isn't like a pen prick. 0:10:34.679 --> 0:10:38.120 Sometimes it's an actual surgical procedure that you may not 0:10:38.200 --> 0:10:40.360 need a lot of times, and we'll get into these 0:10:40.400 --> 0:10:44.840 more specifically, but there's expense involved. Um, a lot of 0:10:44.840 --> 0:10:48.520 times you don't you didn't need to spend that money, 0:10:48.720 --> 0:10:50.760 but you know, it's hard to say, because you should 0:10:50.760 --> 0:10:53.760 be your own medical advocate and spend whatever money you 0:10:53.800 --> 0:10:57.920 can to ensure that uh, the testing is is reliable. 0:10:58.720 --> 0:11:01.440 And then there are things like the time that it 0:11:01.480 --> 0:11:03.800 takes between these things, like all right, we'll see you. 0:11:04.080 --> 0:11:06.520 We need to follow this up with another test, but 0:11:06.559 --> 0:11:08.720 it's gonna take three months to get you in. And 0:11:08.720 --> 0:11:11.640 in the meantime, in those three months, you're stressing out, 0:11:11.640 --> 0:11:14.600 you're up all night, you can't sleep, your sex drive 0:11:14.679 --> 0:11:16.800 is out the window. That sounds like a silly thing 0:11:16.840 --> 0:11:19.240 to talk about, but it's a real thing, especially when 0:11:19.240 --> 0:11:24.480 you're grown ups like us. Yeah, it's important, um, but 0:11:24.559 --> 0:11:27.400 it's it's a here's a study from two thousand nine said, 0:11:27.400 --> 0:11:29.360 granted this is a little old, but it's from the 0:11:29.360 --> 0:11:33.720 Annals of Family Medicine, and when it came to test 0:11:33.760 --> 0:11:40.120 for prostate long colorrectal and ovarian cancers, they found that 0:11:41.120 --> 0:11:47.000 positive false positives. Uh, after four tests they did tests, 0:11:47.200 --> 0:11:50.680 I think either four tests or fourteen test. After four tests, 0:11:51.120 --> 0:11:53.560 you had about a thirty seven percent chance for men 0:11:54.040 --> 0:11:57.360 in the chance for women for false positive. And then 0:11:57.360 --> 0:11:59.360 the more test you got, the more that went up, 0:11:59.640 --> 0:12:03.280 which is distressing. It is something like if you had 0:12:03.360 --> 0:12:07.680 fourteen tests, all fourteen to the tests that they studied, um, 0:12:08.240 --> 0:12:11.240 you had a sixty point four percent chance for men 0:12:11.280 --> 0:12:13.960 and forty eight point eight percent chance for women of 0:12:14.040 --> 0:12:17.400 coming back with a false positive. And again this isn't 0:12:17.440 --> 0:12:19.680 just like it's yes, you have that new lease on 0:12:19.760 --> 0:12:22.840 life on the other side, but studies have shown like these, 0:12:23.080 --> 0:12:26.160 getting a false positive result from a test, it it 0:12:26.200 --> 0:12:29.760 can be emotionally devastating and it can have an impact 0:12:29.840 --> 0:12:32.520 on your finances if you're a Scrooge McDuck type who's 0:12:32.559 --> 0:12:35.120 only moved by the idea of money, well and your 0:12:35.360 --> 0:12:38.600 physical health because of stress. Yeah, because it's not like 0:12:38.640 --> 0:12:41.199 you're not addicted demand which in the time just because 0:12:41.240 --> 0:12:44.440 you're stress eating the whole time. So that's not good 0:12:44.480 --> 0:12:47.720 for you. What was man? Which man? Which was a 0:12:47.800 --> 0:12:51.160 canned sloppy joe starter. Okay, I know it's a meal, 0:12:51.520 --> 0:12:53.760 and well it's more than a meal. A sandwich is 0:12:53.800 --> 0:12:56.200 a sandwich, but a man which is a meal? Oh 0:12:56.240 --> 0:12:58.640 that's right, I got it wrong. You're like, no, it's 0:12:58.679 --> 0:13:02.000 more than a meal. Even it's even greater than the 0:13:02.080 --> 0:13:07.040 ads per prophecies. Uh so the financial costs like you 0:13:07.040 --> 0:13:12.360 were talking about Scrooge McDuck um forty. They did another 0:13:12.440 --> 0:13:15.560 study of about a thousand people, and this was in 0:13:15.840 --> 0:13:19.319 December of two thousand four and the issue of Cancer 0:13:19.559 --> 0:13:23.920 Epidemiology bio Markers in Prevention that is a legit journal, 0:13:24.160 --> 0:13:27.320 just by the title oh for sure, oh eight, and 0:13:27.320 --> 0:13:33.880 then it says and and wakeboarding. More than participants had 0:13:33.880 --> 0:13:37.920 at least one false positive. Of these people went on 0:13:38.000 --> 0:13:41.680 to receive additional care at a cost of about a 0:13:41.720 --> 0:13:47.160 thousand dollars for women and about eleven for men. So 0:13:47.600 --> 0:13:50.800 that's not chump change. No, it's not um And a 0:13:50.840 --> 0:13:53.480 lot of people say, well, who cares, I got insuredce, Well, 0:13:54.000 --> 0:13:56.520 the health care spending is kind of a problem in 0:13:56.559 --> 0:13:59.960 this country. There's apparently in two thousand five, the National 0:14:00.000 --> 0:14:03.959 Academy of Sciences big shout out to them UM. They 0:14:04.000 --> 0:14:07.880 found that there was thirty of healthcare spending was wasteful 0:14:08.040 --> 0:14:12.200 in the United States in two thousand five, and the 0:14:12.240 --> 0:14:15.640 idea of that gave rise to something. There's a campaign 0:14:15.640 --> 0:14:19.520 called Choosing Wisely. Have you heard of that? Know? So 0:14:19.640 --> 0:14:21.840 it's a campaign called Choosing Wisely. They have a site 0:14:21.840 --> 0:14:24.960 called Choosing Wisely dot org. It's a joint effort between 0:14:25.040 --> 0:14:29.160 the American Board of Internal Medicine, so it's physician based 0:14:29.760 --> 0:14:33.640 and consumer reports, and they're basically saying, like, there are 0:14:33.680 --> 0:14:37.680 a lot of unnecessary tests being performed out there that 0:14:37.720 --> 0:14:45.240 are leading to these unnecessary surgeries, unnecessary expenses, unnecessary anxiety, 0:14:45.920 --> 0:14:48.360 and we want to figure out what they are, and 0:14:48.400 --> 0:14:51.520 we want to start advising people against them, or at 0:14:51.600 --> 0:14:55.240 least advising doctors to advise their patients against them because 0:14:55.280 --> 0:14:59.280 they might be unnecessary. And so this campaign UM has 0:14:59.320 --> 0:15:01.600 really kind of had a big impact is we'll talk 0:15:01.640 --> 0:15:03.760 about in a little bit. You know, the idea of 0:15:04.320 --> 0:15:08.680 breast cancer screening has changed. The recommendations have changed from 0:15:08.680 --> 0:15:12.640 what I understand from this Choosing Wisely campaign as UM 0:15:12.640 --> 0:15:16.880 really kind of just shifted things from well, this over 0:15:16.920 --> 0:15:20.280 abundance of caution can't be harmful to actually there are 0:15:20.400 --> 0:15:23.360 some harms involved in an over abundance of caution. Let's 0:15:23.480 --> 0:15:27.480 kind of UM streamline our caution and make it a 0:15:27.560 --> 0:15:31.840 little more UM laser focused. Should we take a break? Yeah, 0:15:31.960 --> 0:15:34.880 all right, we'll take a break, and I'll I'll hit 0:15:34.920 --> 0:15:36.440 you with a stat right out of the gate when 0:15:36.440 --> 0:16:04.960 we come back. All right, So before break, you were 0:16:04.960 --> 0:16:08.960 talking about UM breast cancer and mammograms in particular, And 0:16:08.960 --> 0:16:10.720 there was a study a few years ago in twenty 0:16:11.480 --> 0:16:20.080 two zero about false positive mammograms and breast cancer over 0:16:20.720 --> 0:16:27.200 diagnoses alone at four billion dollars a year billion. So 0:16:27.320 --> 0:16:32.880 it's it's just such a fine line of uh, striking 0:16:32.880 --> 0:16:39.520 the right note with preventative care and over diagnoses. Yeah, 0:16:39.520 --> 0:16:42.880 and here's here's the problem. Like the tests, it's not 0:16:42.920 --> 0:16:46.240 like they're not out there saving people's lives. Yeah, it's 0:16:46.240 --> 0:16:50.000 not like the people like Dr Papa Nicolau who came 0:16:50.080 --> 0:16:53.120 up with the pepsmere said, oh man, this is gonna 0:16:53.160 --> 0:16:56.080 be like a cash register for Western medicine. That's not 0:16:56.120 --> 0:16:59.560 what these tests were designed for. Unfortunately, they are used 0:16:59.560 --> 0:17:03.640 in some circumstances like that, and probably more circumstances than that. 0:17:03.880 --> 0:17:06.520 They're used again out of an over abundance of caution, 0:17:06.600 --> 0:17:09.719 because no doctor wants to be responsible for missing something 0:17:09.760 --> 0:17:12.959 and their patient um and and the leading to their 0:17:13.000 --> 0:17:15.639 patient dying, so they're using this over abundance of caution. 0:17:15.920 --> 0:17:21.400 The problem is that the tests aren't aren't infallible. They 0:17:21.440 --> 0:17:24.960 do have um they do have accuracy problems, and some 0:17:25.040 --> 0:17:28.320 tests are better than others, or another way to put it, 0:17:28.400 --> 0:17:30.480 some tests are worse than others as far as false 0:17:30.480 --> 0:17:35.720 positives go. And it takes the PEPs mirror in particular. UM. 0:17:35.760 --> 0:17:38.640 With the PEPs mirror, it looks for pre cancerous cervical cells. Right, 0:17:39.320 --> 0:17:42.360 three million, three million women in the United States get 0:17:42.440 --> 0:17:48.000 a positive PEPs mirror result UM. From what I understand, 0:17:48.040 --> 0:17:52.040 every year only three thousand of them have a deadly 0:17:52.119 --> 0:17:57.240 cervical cancer and that of women will get a false 0:17:57.280 --> 0:18:01.560 pepsmere in their lifetime. But is the thing. Four thousand 0:18:01.640 --> 0:18:04.959 women who die in the US every year from cervical cancer, 0:18:05.200 --> 0:18:07.399 most of them did not have a PEPs mirror or 0:18:07.480 --> 0:18:09.800 hadn't gotten a PEPs mirror in the last five years. 0:18:09.840 --> 0:18:14.760 So there's a really there's a there's a tough um 0:18:14.960 --> 0:18:20.200 relationship between using the tests and and and overusing the tests. 0:18:20.240 --> 0:18:23.680 And for every say, I think two thousand women who 0:18:23.760 --> 0:18:28.639 undergo a mammogram, one woman's life is saved. Well, those 0:18:28.680 --> 0:18:31.880 two thousand women, they didn't know whether it was gonna 0:18:31.920 --> 0:18:34.000 be whether they were going to be the one whose 0:18:34.000 --> 0:18:36.199 life was saved or not, so that to them or 0:18:36.240 --> 0:18:39.959 to their doctor, it was worth it. Unfortunately, two hundred 0:18:40.040 --> 0:18:43.520 of them will get false positives, and ten of them 0:18:43.520 --> 0:18:49.600 will undergo unnecessary surgeries, painful, unnecessary surgeries to remove non 0:18:49.760 --> 0:18:56.000 cancerous suspicious cells in their breasts. So there's this idea 0:18:56.040 --> 0:18:58.959 where yes, we need to use these tests, and then 0:18:59.000 --> 0:19:01.120 there's also this idea where we need to use these 0:19:01.119 --> 0:19:05.760 tests better or come up with more accurate tests. Yeah, 0:19:05.800 --> 0:19:11.400 I mean, in particular, mammograms UH and screening for colorectal 0:19:11.520 --> 0:19:14.480 cancer are two of the big ones that can show 0:19:14.520 --> 0:19:16.640 a lot of false positives, and they're sort of under 0:19:16.680 --> 0:19:21.000 the microscope as to how we can correct this UH 0:19:21.160 --> 0:19:26.840 moving forward. UM. For instance, mammograms UM correctly identifies breast 0:19:26.880 --> 0:19:31.239 cancer of the time However, uh, if you're younger, if 0:19:31.240 --> 0:19:33.760 you're a younger woman, or if you have very dense breast, 0:19:33.800 --> 0:19:36.840 you're more likely to have a false positive. And so 0:19:37.119 --> 0:19:40.879 because of this, over the past like even ten to 0:19:41.000 --> 0:19:46.760 fifteen years, they've changed the recommended recommended age a few 0:19:46.800 --> 0:19:51.200 times for who when when you should start getting these mammograms. 0:19:51.240 --> 0:19:55.360 It's gone from I think in two thousand nine they 0:19:55.480 --> 0:19:59.080 recommended between fifty and seventy four. Uh, then I think 0:19:59.119 --> 0:20:02.959 it went down, but mean, um, I think it went 0:20:03.000 --> 0:20:05.520 all the way down to forty. At one point, forty 0:20:05.640 --> 0:20:07.920 was where it started, I think where it started, then 0:20:08.000 --> 0:20:10.840 up to fifty and now I think this is the 0:20:10.920 --> 0:20:13.639 latest as of a few years ago, the A c 0:20:13.800 --> 0:20:18.120 American Cancer Society said if you are at average risk, 0:20:18.280 --> 0:20:20.119 and this is probably how they should do it and 0:20:20.200 --> 0:20:23.240 not just a sweeping age. But if you're an average risk, 0:20:23.359 --> 0:20:27.320 you should start at forty five annually, but you could 0:20:27.400 --> 0:20:29.760 begin as early as forty and I would guess that 0:20:29.800 --> 0:20:33.480 means if it if it runs in your family, and 0:20:33.480 --> 0:20:37.960 then after fifty five every other year, like Emily's mom 0:20:38.000 --> 0:20:41.399 and my mom both went through breast cancer, so Emily 0:20:41.440 --> 0:20:45.719 started getting mammograms. I think it maybe even at forty 0:20:46.320 --> 0:20:50.080 because she was in the higher risk group. Yeah, and 0:20:50.080 --> 0:20:55.280 they're no fun to go through, but she is. Uh. 0:20:55.400 --> 0:20:57.120 I think Emily has a good head on her shoulders 0:20:57.119 --> 0:21:02.639 as far as advocating for herself, but also um, not 0:21:02.800 --> 0:21:06.160 going off the deep end. Yeah, that's simily like through 0:21:06.200 --> 0:21:08.480 and through. Like she's not just gonna sit there and 0:21:08.520 --> 0:21:10.959 be like, oh, whatever you say, doctor, and she's like 0:21:11.280 --> 0:21:13.639 that actually doesn't sound quite right. She will stand up 0:21:13.640 --> 0:21:19.360 for herself. Yea. Yeah, advocating for herself it's important. Um. 0:21:19.400 --> 0:21:22.640 So with Mamma Graham's chuck, from what I've seen, nobody's saying, well, 0:21:22.680 --> 0:21:24.680 this is a kind of X ray, so you don't 0:21:24.680 --> 0:21:28.160 want to build up, you know, the radiation. That doesn't 0:21:28.160 --> 0:21:31.199 seem to be the problem with overuse of mammograms. What 0:21:31.280 --> 0:21:33.840 seems to be the problem is that they that well, 0:21:34.119 --> 0:21:36.280 a Mamma Graham is an X ray, and the X 0:21:36.359 --> 0:21:39.600 ray is handed off to a radiologist and they apparently 0:21:39.640 --> 0:21:43.960 are like eight eighty four some high eighty percent effective 0:21:44.240 --> 0:21:48.600 at finding cancerous tumors in breast. Just looking at an 0:21:48.640 --> 0:21:51.840 image of a breast. This trained human being can say, yep, 0:21:51.960 --> 0:21:55.280 there you go right there, circle it initially go follow 0:21:55.480 --> 0:21:59.600 this up. The follow up UM is it results in 0:21:59.680 --> 0:22:04.040 a a biopsy, usually a needle prick biopsy to remove 0:22:04.119 --> 0:22:07.320 some of the cells. Those are examined, and if those 0:22:07.480 --> 0:22:10.879 come back as suspicious, a doctor might say, we need 0:22:10.920 --> 0:22:14.080 to get those cells out. Most of the time those 0:22:14.200 --> 0:22:19.280 aren't actually cancer as cells, but they're still being removed surgically, 0:22:19.520 --> 0:22:24.160 which is painful, costly, and can be a problem emotionally 0:22:24.480 --> 0:22:27.119 to have to go through that surgical procedure to have 0:22:27.600 --> 0:22:30.600 cells removed that you didn't need to have removed. That's 0:22:30.640 --> 0:22:34.200 the that's the problem with with UM mammograms as far 0:22:34.240 --> 0:22:38.960 as getting them frequently, and supposedly, between ages forty and fifty, 0:22:39.160 --> 0:22:41.480 a woman has a fifty to sixty percent chance of 0:22:41.520 --> 0:22:44.680 getting a false positive result from a mammogram. Yeah, man, 0:22:44.800 --> 0:22:48.520 I mean a sixty chance. Yeah. And again, no one's saying, oh, 0:22:48.760 --> 0:22:51.600 don't get mammograms. They're gonna just totally screw you up. 0:22:51.760 --> 0:22:55.520 It's more like medical community, we need a better way 0:22:55.720 --> 0:22:58.639 to to find to keep an eye on breast cancer. 0:22:59.240 --> 0:23:01.680 I mean they're trying. I sure they are, of course 0:23:01.720 --> 0:23:04.919 they are. In Colorectal cancer is a perfect example. UM. 0:23:04.960 --> 0:23:07.760 It is the second leading cancer related death in the 0:23:07.880 --> 0:23:11.119 US right now? Um was it? Say here? A hundred 0:23:11.200 --> 0:23:15.840 thirty two thousand, seven hundred new diagnoses in two thousand fifteen. 0:23:16.680 --> 0:23:22.479 And one of the big problems with colorectal cancer is 0:23:22.520 --> 0:23:24.720 that not a lot of well, I'm saying a lot 0:23:24.720 --> 0:23:29.159 of people, but I think about fifty of people don't 0:23:29.680 --> 0:23:37.440 follow up on a recommendation to get a colonoscopy because 0:23:37.600 --> 0:23:40.960 they don't want to get a colonoscopy. Yeah, so that's 0:23:40.960 --> 0:23:43.560 a problem. Have you got one of those? Not yet? 0:23:43.960 --> 0:23:46.280 You know not. I haven't either. I'm really really not 0:23:46.359 --> 0:23:49.200 looking forward to it. And I was researching it today 0:23:49.400 --> 0:23:51.840 and just almost fainted like three or four times while 0:23:51.880 --> 0:23:56.760 I was reading the procedure. About the procedure, Yeah, it's hardcore, man. 0:23:56.840 --> 0:24:00.919 There's like a finger with tube that they stick in 0:24:01.000 --> 0:24:05.000 your anus, past your rectum up to your colon. The 0:24:05.240 --> 0:24:07.680 c seesme I think it is, which is the top 0:24:07.720 --> 0:24:12.480 of your colon, which is basically where the your rib 0:24:12.560 --> 0:24:17.520 cage ends on your left side, that's your sesome. They 0:24:17.520 --> 0:24:19.520 go all the way up there and it has like 0:24:19.560 --> 0:24:22.560 a camera and a light on the end, and basically 0:24:22.560 --> 0:24:25.760 what they're doing is visually inspecting the inside of your colon. 0:24:26.240 --> 0:24:28.720 If they see something that they find suspicious, they can 0:24:28.760 --> 0:24:31.600 put four steps through the tube and take a sample 0:24:31.640 --> 0:24:34.280 of it and then just you know, come on back out. 0:24:34.720 --> 0:24:37.800 Normally they'll they'll give you a sedative for this. UM. 0:24:37.840 --> 0:24:40.560 They also give you I can't remember the name of 0:24:40.600 --> 0:24:44.560 the drugs um, but it basically makes you forget that 0:24:44.640 --> 0:24:47.159 it ever happened. Like you can prevent you from forming 0:24:47.200 --> 0:24:50.240 memories during the procedure. But most people don't want to 0:24:50.280 --> 0:24:53.560 go through this, even though it's extremely effective. It finds 0:24:53.600 --> 0:24:58.880