Well I have been carrying around Ernest Curtis’s essay on risk factor medicine. Ernest is a cardiologist and cardiology actually is a place where risk factor medicine is well developed. I have pleased to say that Ernest thinks risk factor medicine is hocum and bunkum–I think it is too.
So I respond here to Ernest’s excellent discussion and try to offer some reasons why risk factor medicine has become such a big deal and dominates public policy discussions and patient education–public health people love to talk living healthy and such.
You see in the practice of medicine we are always reminded of risk factors that increase heart disease and cardiovascular events. They are called risk factors, trouble is I think risk factor analysis studies are in the range of noise and Ernest very eloquently and professionally exposed the unreliable nature of risk factor talk and patient education. Eating healthy and living healthy are overrated.
Ernest confirmed some of the concerns I had in his essay.
However I wanna go further–because recently I saw that some idiot from the American Cancer Society claimed that a significant percentage of cancers are preventable. I would demur–no, because the ACS guy is a jackass, I would say he is ignorant. All our dreams about preventing cancer? Tinkerbell and pixie dust talk. Eat this, don’t eat that, don’t get too fat, increases your breast cancer risk. A lot of preventable things are proven, but they don’t come close to the impact the ACS guy claimed. The majority of cancers are caused by age related cell line polyploidy and bad luck but also a failure of immune system function in elimination of the bad cell lines.
Lifestyle modifications and nannyism wants cancer to be preventable–but wanting doesn’t make something true.
1. This is the same Cancer Society that ignores age as a dominant factor in developing cancer.
2. This the same Cancer Society that claims one-third of cancers are caused by tobacco, a claim that is not supported by reliable evidence.
3. This is the same Cancer society that claims second-hand smoke at ambient levels causes cancer, with no reliable evidence of such a thing except the loony no threshold linear modeling methods of the scare mongers.
4. This is the same Cancer Society that says one-third of cancers are caused by what we eat, one-third are caused by tobacco, and one-third by environmental toxins. Nonsense.
So how does that fit with Ernest debunking of risk factor scares or hypotheses?
Well it goes like this, as Ernest Says, when multiple causes are proposed it means that no one knows the cause and is just using associations, an observed relationship of events–easily possibly caused by randomness and not proof.
However, to have risks, and many risks, is a great opening for the nannies, isn’t it–if you do this, if you avoid that–on and on–opportunities for meddlers and public policy mandarins.
So risk factor medicine in fact provides a jobs program for “Preventive Medicine” preachers.
So many people like to preach–makes them feel special and superior.