Risk Factors and preventive medicine delusions

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.


7 responses to “Risk Factors and preventive medicine delusions

  1. @john1282
    Curtis is one of the smart guys on this site!

  2. Ditto. Huge Curtis fan!

    • Kudos from people I respect and admire such as Michael, Bob, and Sandy mean more to me than I could ever express. I am deeply appreciative for all that I have learned from the writings of these three brilliant and hard working analysts of scientific truth.

  3. 5. This is the same Cancer Society that downplays and pooh-poohs the well-documented link between abortion and breast cancer, and ignores the fact that hormonal contraception is considered carcinogenic on the same level as asbestos by the WHO.

  4. ernestncurtis

    John, another reason that risk factor analysis has become such a big deal is that it is extremely easy research to do. No heavy lifting at all. Just send questionaires to a number of people and have your grad students do some basic followup and run the numbers through the computer to generate statistical associations. Ask enough questions about various life style factors and you can keep going back and remining the data bank for more associations,and, more importantly, more published papers.
    Another reason for the popularity of this approach is that it gives a “scientific” rationale to that endless stream of busybodies who are never happy unless they can control the behavior of others. And we musn’t forget the strain of Puritanism that was revived in the Second Great Awakening in the 1830s when evangelical Protestant pietism swept over large portions of the country. This was a source of great political and cultural conflict between the evangelical pietists on one side and the waves of immigrant Catholics and high church Lutherans on the other. The pietists favored an ascetic life style and tended to regard anything remotely pleasurable as sinful. Couple this with a messianic zeal to convert others and stamp out sin and you have the foundation for the hordes of “moralists” today that seek to force everybody else into a life style of “clean living” and devoid of sin. These people have long ago forsaken their religious roots but have lost none of the messianic zeal to save people from themselves .

  5. I’d be very interested in anyone’s effort to get this author (an MD) to respond to Rep Tim Murphy’s/TAC efforts to expand “mental illness” screening, early “detection”, “prevention” and AOT. Then sharing with Murphy and his supportive legions for their comments. Could the author and his followers become needed recruits for anti/critical psychiatry??-_____________________________________________________________ ‘… 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. ..’.- the proposed Helping Families with Mental Health Crisis Act by Rep Murphy- spuriously represents this through psychiatric “disease” mongering, and an serious assault on scientific integrity, medicine, and human/civil/patient rights and liberties!

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