The 12 Screenings That Manufacture the Patients They Claim to Find

[John Hilton]

The 12 Screenings That Manufacture the Patients (which) They Claim to Find

https://unbekoming.substack.com/p/th...at-manufacture
note: article kindly posted by Ewan in next post below

[Ewan]

Posted by John Hilton (here)
The 12 Screenings That Manufacture the Patients (which) They Claim to Find

https://unbekoming.substack.com/p/th...at-manufacture

In 2022, the New England Journal of Medicine published the results of the NordICC trial — the first randomised controlled study of colonoscopy screening ever conducted. Over 84,000 people were followed for ten years. The trial found an 18% reduction in cancer incidence and no significant reduction in cancer deaths. To prevent a single case of colorectal cancer, 455 people had to be invited for screening. To prevent a single death, the numbers were statistically indistinguishable from zero.¹

This is the pattern.

Across the major screening programmes — mammography, PSA, Pap, colonoscopy, lung CT — when the question is whether the screened population actually outlives the unscreened population, the benefit largely disappears.² The statistic the programmes advertise is disease-specific mortality: deaths from the disease the test is looking for. The statistic they bury is all-cause mortality: whether the screened group, taken as a whole, lives longer. The two numbers are not the same. You can reduce deaths from one disease while total deaths remain flat — because treatment has killed as many people as the disease prevented, or because the disease you found was never going to kill anyone.²

The screened do not live longer than the unscreened. They are more likely to spend their remaining years monitored, biopsied, cut, and medicated for conditions that would not have harmed them. This essay catalogues twelve tests that produce that conversion, organised by the four mechanisms through which it is achieved.

Always handy to give others a clue about what they might find at the link imo. Cheers, John.

[John Hilton]

Posted by Ewan (here)
Always handy to give others a clue about what they might find at the link imo. Cheers, John.

1. The clue is in the title.
2. I won't infringe copyright. It isn't my article. I couldn't commit the time to list everything that the article covers.
3. If you like the article, please click on the link and click the "like" button.

[RunningDeer]

Adding this section to the article:

How to Explain This to a Six-Year-Old

Some grown-ups have machines that look inside your body to find things that might be dangerous. They say finding things early is good, and going to the doctor sounds safe.

Here is what they don’t tell you. The machines find lots of small things that were never going to hurt you. Sometimes they find nothing at all and say they found something. Sometimes they find a piece of something and pretend it is the whole bad thing.

Once the machine says it found something, the grown-ups cut it out, or give you medicine to fight it, or make you come back every year to check. The cutting and the medicine often hurt you more than the thing would have.

The grown-ups also have a rule about what counts as sick. They get to change the rule. Every few years they change it so that more people are called sick. The people who change the rule are often paid by the companies that sell the medicine for being sick.

You can feel fine on Monday and be called sick on Tuesday, and nothing inside you changed. Only the rule changed.

[ThePythonicCow]

The twelve screenings considered:

1. Bone Density (DEXA) and the Manufactured Pre-Disease
2. Cholesterol
3. Blood Sugar -- "Prediabetes"
4. Mammography
5. Colonoscopy
6. CT Scan -- The Screening Test That Causes the Disease It Looks For
7. PSA Testing
8. Prostate Biopsy
9. Pap Smear and HPV Testing
10. PCR
11. Antibody Tests
12. BRCA Testing and Prophylactic Mastectomy

[RunningDeer]

How Big Pharma Turns Healthy People Into Lifelong Customers (1:11:00)

• KenDBerryMD
• 3.71M subscribers
• July 30, 2026

Big Pharma and Big Medicine do not make money only by treating sick people. The medical market also grows when healthy people are screened, labeled, medicated, monitored, and treated for years or even for life.

Alan Cassels has spent more than 30 years investigating the gap between medical evidence and medical marketing. He is the co-author of ”Selling Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All Into Patients,” and the author of ”Seeking Sickness: Medical Screening and the Misguided Hunt for Disease”. His work examines disease mongering, overdiagnosis, pharmaceutical marketing, polypharmacy, medical screening, and the financial incentives that can turn ordinary people into lifelong patients.

In this conversation, we examine:

1. How cholesterol became a massive market for lifelong medication
2. How relative risk can make a small treatment benefit sound enormous
3. Statin research, adverse effects, and the difference between lowering LDL and improving meaningful outcomes
4. How an accurate screening test can still leave a patient worse off
5. False positives, over diagnosis, and the claim that “screening saved my life”
6. How one drug’s side effect can be mistaken for a new disease and treated with another drug
7. Why medications are much easier to start than to stop
8. How GLP-1 drugs are being promoted to progressively healthier people
9. What MRI abnormalities can and cannot prove about pain
10. Operations that have failed to outperform sham surgery

This is not an argument against medicine. Modern medicine can save lives and relieve tremendous suffering. It is an argument for honest evidence, absolute numbers, meaningful informed consent, and medical care that serves the patient rather than the market.

Source: https://youtube.com/watch?v=2LqmlWpaiEE

AI summary and key points:

The discussion between Dr. Ken Berry and Allan Cassels explored how modern healthcare systems can sometimes expand the definition of illness, leading to the diagnosis and treatment of people who may not actually benefit from intervention. Cassels discussed the concept of disease mongering, where normal experiences, risk factors, or minor abnormalities can be reframed as medical conditions requiring treatment. He explained that this can happen through pharmaceutical marketing, clinical guidelines, screening programs, and financial incentives, even when healthcare professionals are acting with good intentions. The speakers emphasized the importance of understanding absolute risks rather than misleading relative risk reductions, and focusing on outcomes that truly matter, such as improved quality of life and longer survival.

The conversation also examined the risks of over-screening, over diagnosis, and over treatment, including unnecessary imaging, procedures, and medications that may cause harm without providing meaningful benefits. Examples included detecting harmless abnormalities through scans, unnecessary surgeries, and the challenges of managing multiple medications in older adults. The speakers encouraged patients to take an active role in healthcare decisions by asking questions, understanding potential benefits and harms, and recognizing that sometimes monitoring or lifestyle changes may be more appropriate than immediate treatment. They concluded that effective healthcare should involve personalized decisions, honest communication, and careful consideration of whether an intervention will genuinely improve a person’s health.

Key Points

• Healthy people can become targets of medical marketing when risk factors, borderline findings, or normal variations are framed as diseases requiring treatment.
• Disease mongering refers to expanding the definition or awareness of conditions in ways that may increase markets for medications, tests, or procedures.
• Pharmaceutical marketing does not necessarily require dishonest doctors; well-meaning clinicians can be influenced by systems, guidelines, education materials, and industry messaging.
• Relative risk reductions can sound dramatic while hiding small absolute benefits.
• Patients should ask: “How many people like me actually benefit?” rather than only asking whether a treatment works.

• Cholesterol was discussed as an example of a risk marker that has sometimes been treated as a disease itself.
• Changing diagnostic thresholds can greatly expand the number of people classified as needing treatment.
• Surrogate markers (such as cholesterol numbers or bone density) do not always translate into improved lifespan or quality of life.
• Osteoporosis medications were discussed as an example where improving a measurement does not automatically mean preventing meaningful outcomes.
• Over diagnosis occurs when tests identify abnormalities that would never have caused symptoms or harm.

• Screening can produce false positives, unnecessary procedures, anxiety, and treatments.
• Lead-time bias can make screening appear more successful because disease is detected earlier without necessarily extending life.
• MRI findings often reveal abnormalities in people without symptoms, complicating decisions about treatment.
• Sham surgery trials have shown that some procedures may provide little or no benefit compared with placebo procedures.
• Polypharmacy is a major concern, especially among older adults taking multiple medications.

• Deprescribing and medication review are important parts of quality healthcare.
• GLP-1 medications may provide substantial benefit for some patients but should not automatically be generalized to everyone.
• Lifestyle interventions such as exercise, nutrition, and social connection remain important components of health.
• Most medical decisions are not emergencies, allowing time for research and discussion.
• Shared decision-making requires balancing evidence, risks, benefits, and patient values.

The strongest shared conclusion is that medicine works best when clinicians and patients critically evaluate evidence, avoid automatic treatment decisions, and weigh potential benefits against harms. Skepticism and questioning are valuable, but they should be paired with careful interpretation of high-quality evidence rather than assuming that most medical recommendations are primarily driven by commercial motives.