Biomedical Engineering Reference
In-Depth Information
Table 3.
Balancing cancer risk.
Great health inequity exists among smoking-related diseases
Novel prevention strategies are likely to lead to similar inequity
The creation of meaningful incentives to reduce risks will be essential
Individually tailored messages will have a greater power to change lifestyles
Biomarkers of risk will enhance the validation of cancer preventive drugs
Novel providers of risk assessment and correction will emerge
reveal that every person screened has a predisposition to certain diseases. People
will have to learn to live with risk.
Today the average age of a patient diagnosed with cancer, is 68. Improvements
in screening, detection and diagnosis will reduce that number. A predisposition for
cancers that manifest in a patient's 70s or 80s will be found out in a patient's young
adult life, and corrected successfully before the patient reaches his or her 40s. Age
increase will remain the strongest risk predictor. Most of what has been described
is already happening in some form, but the computing power that will be used in
the future to calculate risk and predictions, will be unimaginable in scale. Screening
programmes will be developed on a national basis as long as they are simple, robust
and cheap. Patients will expect the screening venues to be convenient places such as
shopping malls. They will also expect screenings not to be painful or overly time-
consuming. Health professionals will insist that any programme is accurate and
does not give misleading results. Governments will insist that a programme's costs
lead to more effective use of other resources. Novel providers of risk assessment
services will likely emerge (Table 3).
Detecting Cancer
Cancers are fundamentally somatic genetic diseases which result from several types
of causes: physical, viral, radiation and chemical damage, chronic inflammatory
change, immuno-surveillance, and failure of apoptosis. In the future, cancer will
not be looked at as a single entity, it will be considered a cellular process that changes
over time. Many diseases that are today labelled as cancer will be renamed because
their development will not reflect the new paradigm. Patients will not accept cancer
as a single disease. Increasingly, they will come to understand it as a cellular process.
Many more elderly people will have increased risk or some type of precancer. This
has huge implications for cancer services. Today, most diagnoses of cancer depend
on human interpretation of changes in cell structures seen down a microscope.
Microscopes will soon be superseded by a new generation of scanners to detect
molecular changes. These scanners will build up a picture of change over time,
imaging cellular activity rather than just a single snapshot. We will be able to probe
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