[jyl]

Good book about cancer. "The Emperor of Maladies".

The biopharma industry is spending billions (ballpark est, $100BN/yr) on cancer research and treatment. Remarkable progress but still so far to go. Extraordinarily complex group of diseases, our understanding is still very limited and the ability to find "druggable" pathways is also very limited.

The interesting thing is that the economic incentives to develop better cancer screening are weak. If an insurer pays $1000/pp to screen 1,000 insureds for a particular cancer, and detects early stage cancer in 1 of those persons, the insurer has spent $1MM on screening to find 1 case. It won't save $1MM in medical costs - it may not save any money at all, as a cancer discovered early may actually cost more to treat than a cancer discovered very late. Thus new screening tests have a hard time getting traction and have to cost very little to have a chance at commercial success. I don't know of any company that has become a really big, commercially successful business based on early cancer detection. It is far more lucrative for biopharma companies to develop treatments than detection, and not especially lucrative for insurers to fund detection.

I think what I just described is the biggest structural problem with how we approach cancer.