Is Toshiba's tool for detecting cancer dangerous?

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The future cancer detection machine of the Japanese giant Toshiba, whose prototype was unveiled Monday, November 23, 2019, would include bias. The blog Hard to swallow, managed by Jérémy Anso, a researcher from the New Caledonia-based Institute for Development Research (IRD), ensures that the device "does not promise any medical advances for the health and well-being of the patient". However, the manufacturer wants to be formal: it works in 99% of cases and, for 13 variations of the disease – namely the stomach, the esophagus, the lungs, the liver, the bile ducts, the pancreas, the colon, ovaries, prostate, breasts and bladder, as well as sarcomas (tissues) and gliomas (brain).

A SIMPLE BLOOD ANALYSIS

According to Toshiba, a drop of blood is enough to establish an indisputable diagnosis. The method used by the machine, already implemented by companies like Toray Industries, is not controversial since it relies on the analysis of the concentration of micro-RNA molecules in the blood, secreted by the cancer cells.

The chip designed by Toshiba reduces the duration of the analysis to just under two hours for a cost of 20,000 yen (160 euros) – the manufacturer however does not specify the current terms of such an examination. "We have an advantage over the competition in the degree of reliability in the detection of this disease, as well as in terms of time and cost of detection"Koji Hashimito, director of scientific research at Toshiba, said at a press conference. The Japanese firm has placed its medical division at the heart of its strategy, exposed last April, for the next five years, with a lot of AI and automation.

TOWARDS INCIDENTALOMES

Because of the importance of early treatment for cancer treatment, the device is a source of hope for the medical community. French hospitals, like Lyon, are working on a similar method. But, according to Jérémy Anso, the efficiency of the device can not, at this time, not be certified independently. The biologist says that he could, unintentionally, cause a significant increase in the rate of incidentalomas – cases in which the discovery of a pathology is by chance, having escaped the vigilance of a doctor. "This machine concentrates all the excesses that many experts denounce in the management of cancer.It will be at best useless, at worst dangerous", he predicts a blog note.

Various issues are raised. First, even though Toshiba announces a reliability of 99%, the biologist assures that "the specificity will be 0%". Understand that the machine will announce a cancer, without specifying which one is among the thirteen of the list. This implies a battery of complementary tests to determine it … and a surplus of fatigue for the patient.

INEVITABLE CONSEQUENCES ON THE PSYCHOLOGICAL PLAN

Beyond this lack of precision, Jérémy Anso points to the "extremely heavy psychological weight" what will imply such a machine. Designed for use in conventional health check-ups, it will automatically assign a "terrible label of cancer" to patients who do not necessarily experience daily symptoms. This could result in higher than normal mortality, "a higher suicide rate or a therapeutic relentlessness".

The subject of overdiagnosis and overtreatment is debated among health professionals. For example, a mammogram revealing the presence of a tumor mass will certainly lead to the removal of the breast … whereas the latter could have had no impact on the patient's life. "in 10 to 50% of cases". It's all about technology that needs to be rethought.

Designed in conjunction with the Tokyo Medical University, Toshiba's device is only at the experimental stage and should not see the light of day "several years". The first clinical trials in real conditions will be carried out during 2020. "Population studies will also be needed to check if patients who use this material have a risk of mortality, specific for type of cancer and total, lower than the others"prejudges Jeremy Anso.

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