A revolution is underfoot in the world of diagnostics

In the second extract from his new book Growing Young, Sergey Young explains why early diagnosis is so profoundly important to longevity.

Longevity.Technology: Ahead of the launch of Sergey Young’s new book The Science and Technology of Growing Young on 24th August, we are delighted to showcase another extract. Investor and thought leader, Young, who founded the Longevity Vision Fund aims to bring a healthy extended lifespan to a billion people.

Encouraging people to take charge of their own healthspan, Young’s book details the practical steps the reader can take to improve their chances of living to 100 – and beyond! He also shares his vision of the future, exploring the cutting-edge breakthroughs that are on the way.

Early and accurate detection of diseases is the key to addressing the prevention of premature death dimension of longevity. Unfortunately, our current paradigm of diagnosis is in a deep crisis for three reasons: it happens too late; it is inaccurate; or it is simply unattainable. But a revolution is underfoot in the world of diagnostics. Here is what it will look like:

Diagnosing Early

Medicine today is reactive, not proactive. Until you already have symptoms, of course you do not go see a doctor, except for routine medical examinations. Why would you? The answer can be found in the story of popular Carnegie Mellon computer science professor Randy Pausch. His 2007 “Last Lecture” has been viewed more than twenty million times on YouTube. Part of a lecture series organized by the university on the premise of giving a lecture “as if it were your last.” But for Randy Pausch, it really was. A month before he delivered the Last Lecture presentation, Professor Pausch was diagnosed with terminal pancreatic cancer. He had six months to live.

The subsequent loss of Randy Pausch was a tragedy, not just for the value of his life and the wisdom he had to share with students and followers around the world but also because it could have been avoided. When caught in stage 1, the five-year survival rate for pancreatic cancer across all age groups is 34 percent. Had the 46-year-old, bicycle-riding, pushup-performing Professor Pausch been diagnosed earlier, it is reasonable to believe that his chances of survival would have been considerably better than the average. But pancreatic cancer gives few early warning signs and is difficult to diagnose with existing tests. By the time symptoms send sufferers to the doctor, the disease is often already in its most advanced stage, where the survival rate drops to just 3 percent. Put simply, diagnosis of pancreatic cancer is almost always too late.

The importance of early diagnosis of cancer cannot be overstated. Early diagnosis of breast, cervix, colon, and bladder cancer results in survival rates that are 3.6, 5.43, 6.3, and 20.82 times higher than their respective rates for late-stage diagnoses. Early diagnosis is largely responsible for declining cancer mortality rate of 1.5 percent per year.

Early diagnosis is equally important for heart disease and stroke, the number one and number two causes of death worldwide. The underlying conditions of these health hazards are high cholesterol and hypertension – the so-called silent killers. These afflictions usually have no symptoms in their early and middle stages, and can therefore go undiagnosed until they reach dangerous levels. There are hundreds of millions of people worldwide who live with an undiagnosed disease – some in great pain and distress, others completely oblivious to their condition. One hundred million people have undiagnosed thyroid disorders. Another 232 million live with undiagnosed diabetes; 15 percent of all people with HIV and 30 percent of all people with tuberculosis are similarly unaware of their diseases. Up to 30 percent of Parkinson’s sufferers and up to 80 percent of those with Alzheimer’s disease are not punctually diagnosed. And of the more than one billion people worldwide living with hypertension, as many as half do not know about it.

In fact, when you dig into the nearly sixty million lives lost around the globe each year, more than thirty million are from conditions that are restorable if caught early. Only one item on the World Health Organization’s top ten causes of death – road accidents – isn’t a partially or fully treatable condition (and that one will soon be eliminated by self-driving cars). The problem is – we just are not diagnosing people early enough.

Diagnosing Accurately

The second problem with diagnosis today comes when the sick do get checked but are given the wrong diagnosis. For a view into this troubling matter, Google Doug Lindsay. The St. Louis, Missouri, native suffers from an autonomic nervous system disorder known as autonomic dysfunction, which killed his mother and left him bedridden for eleven years.

With just three years of undergraduate biology under his belt, the young man used that time to make his own diagnosis. He then helped invent the novel surgical procedure that saved his own life. But what’s really significant about Lindsay’s story is that he even had to go to such great lengths in the first place. By the time Doug Lindsay fell ill, autonomic dysfunction had been a known condition for twenty years. There was even a dedicated center for this class of diseases at Vanderbilt University. But repeatedly, the best doctors at the best medical centers using the best diagnostic equipment told Doug Lindsay that he was fine, and his disease “did not exist.”

“According to my blood work,” Lindsay told me, “my health was great. But my life was absolutely terrible. When you fly on a plane, you are confident that the pilot knows everything that there is to know about aeronautics, and that’s how you will survive the journey. But in my case, it was like I had to take over and fly the plane. You don’t know what is going to happen, and you are just left to guess, and quite possibly – to die.”

The global medical system is overwhelmed with patients. In a 2017 international study of more than twenty-eight million doctor consultations among sixty-seven countries, it was revealed that the average time spent with a doctor is five minutes or less for half of the world’s population, and as low as twenty-eight seconds in places like Bangladesh.

Even in the United States, average visit time doesn’t crack twenty minutes, with only 11 percent of patients spending twenty-five minutes or more visiting their primary care physicians. But beyond the issue of time is another worry – it is humanly impossible for doctors to keep up with all of the latest medical developments. There are some thirty million peer-reviewed medical papers in the US National Library of Medicine, a figure that is growing by about one million papers per year. Doctors are human beings, with families and lives of their own. Even the most dedicated, curious, and intelligent doctors have no chance of reading every relevant research report and case that comes out.

According to researchers from Johns Hopkins, 40–80,000 patient deaths and as many as 160,000 cases of serious harm can be attributed to diagnostic errors every year in the United States. Twelve million American adults are estimated to be misdiagnosed in some way during the same lapse of time. Women are at the highest risk of misdiagnosis, with various studies revealing a 30–50 percent greater likelihood than men to receive an incorrect medical diagnosis.

Diagnosing Accessibly

Finally, and tragically, there is a third element to the crisis of diagnosis: for a large percentage of the world’s population, there is little or no access to diagnosis in the first place. A staggering 56% of the world lives in rural areas, far from the advanced hospitals, diagnostic equipment, trained operators, repair technicians, and spare parts that are currently needed to provide diagnostic services. Sub-Saharan Africa is the most affected by this lack of diagnostic access, with some 83 percent of its inhabitants (around seven hundred million people, or two times the US population) living in poor, rural, and underserved areas.11 In fact, most of the ten million annual deaths from cancer worldwide occur in low- to middle-income countries, where there is simply inadequate access to diagnostic tools like imaging machines, lab tests, and trained technicians.

The good news? This set of problems with diagnosis is about to change.
In the Near Horizon of health care, diagnostics will move from the current reactive approach to one that is overwhelmingly proactive. It will shift from the current, error-prone model of relying on an individual doctor’s experience to one based on connectivity, data, and sophisticated artificial intelligence. And it will move from a world where diagnostic devices are large, expensive, and centrally located to one where they are small, inexpensive, and ubiquitous. As a result, your own chances of catching and stopping disease far in advance will become radically unshackled from the limitations of country, cost, caretakers, and convenience.

Read the first extract HERE – Moving from Internet of Things to Internet of Bodies
Catch our video interview with Sergey in which he discusses his new book, longevity horizons, disruptive tech and how we are moving towards radically extending our lifespan and healthspan.

Images courtesy of Sergey Young

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