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Tell us the ugly truth then paint a happy picture.

“for one in six deaths around the world, killing nearly 10 million people a year globally and over 600,000 people a year in the US.”

A lot of reduced deaths come from less smoking and early detection. We will eventually get there but we need a lot more research.

Get a colonoscopy at 45. We are seeing a big increase in younger people.

https://www.cancerresearch.org/blog/colorectal-cancer-awaren...


> Get a colonoscopy at 45. We are seeing a big increase in younger people.

N.B. this is not just an increase in detection (as could happen with more/better screening where the true rate isn't changing), but mortality:

> In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s. https://www.cancer.org/cancer/types/colon-rectal-cancer/abou...


It's certainly the case that colorectal cancer is becoming more common, and among younger people. Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick.

However, the fact that mortality has been decreasing above the age of frequent screenings, and increasing below that age, tells us that whatever the problem, the symptom (cancer) could be addressed with better screening, leading to earlier detection and treatment.

Mortality is increasing in young people because they don't get screened, so when it does happened no one catches anything until it's too late.

If the age for recommended regular colonoscopies was 40 or 45, we would see the same mortality reduction above that cutoff.


> Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick.

I think obesity is the main confounder in all such statistics. Thats the thing that has most markedly gone up over the past decades


You don't know that. Environment is much more polluted, and thus is our food. We move less. And so on.

Whose environment is much more polluted. In the developed world, pollution is decreasing. For the U.S., for example: https://gispub.epa.gov/air/trendsreport/2024/

That's showing that air pollution I would guess mostly from cars has gone down since 1990.

There are lots of other new chemicals not shown on that chart that are in our food and clothes and everything, particularly almost everything modern babies in the US come in contact with.


While PFAS and microplastics and the like are a huge problem, you can't just dismiss the major efforts done over the decades to reduce pollution and improve health; wood / coal fire bans, mandatory catalytic converters, ban on asbestos and CFCs, lead-free fuel and paint, EVs, renewable electricity generation, emission zones, trash collection & safe disposal, smoking bans and discouraging measures, etc. It's not an either/or, and not celebrating successes means there will be less inclination to also solve the newly discovered issues.

Fair points honestly. We tried a lot of awful stuff in the 1900s that has been stopped and that should be celebrated.

There's also a lot that was never stopped, and more and more coming all the time.


There is also a lot less toxic chemicals around nowadays such as flame retardants, DDT, lead (petrol), asbestos, PCB etc.

Obesity is a symptom; food poverty, financial poverty, lifestyle choices, city design, culture, etc etc etc.

This mindset drives me nuts. It's like the rhetorical opposite of victim-blaming. It takes something that is within an individual's locus of control and pretends they have zero agency in the matter.

Last week I finished a two month diet where a big chunk of my weekly calories and nutrients came from cheap staples I prepared myself (specifically brown rice, black beans, steelcut oats, spinach, and eggs).

Aside from the food, the cost was 1. watching some ads in the free version of the calorie counter app I used to make sure I was getting the nutrients I needed and 2. ~$30 for a food scale so I could be precise about what I was eating.

Circumstances make it easier to be unhealthy but what I did is attainable by the vast majority of obese people.


It's complicated because it's both, with varying levels of influence.

Obviously, it cannot be 100% on the individual. Because then, how did we get an obesity epidemic? Did people somehow, magically, become more lazy since 1970? That doesn't sound plausible to me.

It's systemic in nature. Consider tobacco use, a problem we've largely solved in the US. We went from something like 50% of people smoking in 1960 to about 10% now. In young people, the results are even more drastic. It's sort of magic - a reverse obesity epidemic.

How did we do this? A combination of things. Of course people worked very hard to quit, but they also got PSAs and their doctor's helped them. And then we made it much, much harder to smoke.

The thing is, people are creatures of influence and habit. Much of what we do is because it's low resistance. We've allowed obesity to become a systemic problem because of our food available, our culture, and our lifestyles.

It's not that some place like, say, Paris is healthy. But it's a lot easier to be accidentally not-obese in Paris, France than in Paris, Texas.


The question of how someone who wants to lose weight should do so doesn't really have much to do with why people in general are more overweight than decades ago. People in the 80s and 90s had a lot of processed foods, didn't generally use food scales, and calorie counter apps hadn't been invented yet.

FOBT which you can do painlessly at home for a few dollars is not meaningfully less preventative than an invasive colonoscopy and carries almost no risk. https://www.nejm.org/doi/full/10.1056/NEJMoa2208375

Very true, and this is what caught my father's bowel cancer and saved his life.

That said, for someone with increased risk, nothing compares to a colonoscopy - at it does a better job of catching things early, before you start getting blood in your poo.

But if you are at a standard risk, doing a fobt every couple-few years is hugely important. Ask your doctor now!


The superior stool based test would be the FIT-DNA test, which compares favorably to a colonoscopy in sensitivity. These are covered by insurance in the US.

www.nejm.org/doi/full/10.1056/NEJMoa1311194


However, if pre-cancerous polyps are found during a colonoscopy, they can be removed right then.

Of course, the best prevention is one that people actually do.


FOBT = Fecal Occult Blood Test (A highly sensitive test for detecting blood in poop even at tiny concentrations).

How effective is it when you get one every year? The idea of a colonoscopy scares the shit out of me (pun not intended).

I have done mine at 50, you are half asleep, does not hurt, you do not remember anything. Fasting day before is the worst part.

All in all, nothing to worry about, just do it.


While earlier detection has been beneficial, there's such a thing as too much. Really, there's balance to be struck. For instance the detection procedures themselves (even things like non-invasive imaging) aren't risk free themselves, false positives can set off a chain of events that carry their own harm, and even it's not at all uncommon to develop cancers you "die with" instead of "die from" but once they're detected you have to assume the worst - and treatment itself causes its own form of harm.

Getting one annually is not recommended for most patients. After my bowel resection, I had annual colonoscopies for five years, then every three years, now every five (the normal recommendation for my age cohort).

Colonoscopies are no big deal from my perspective, but they do have some risk; bowel perforation being the primary one. The prep stuff is the worst aspect for most patients; I used to love lemon lime Gatorade before I used it once as a way of drinking the liquid laxative...


Thanks for the reminder. My containers to shit in are waiting to be picked up from the doctor's office.

Looks like colonoscopy is better from your link.


The issue with things like cologuard is they really only detect cancer. Colonoscopies can prevent cancer by having polyps removed before they turn into cancer.

Colonoscopy is a more invasive procedure obviously, but complication rates are very low. It's worth it to find a great gastroenterologist to do the procedure.


Yeah wish I had grabbed one last time I had an endoscopy.

Until things radically change, people are always going to die of something. The more people avoid death from other things, the more people live long enough to die from cancer.

I know at least a dozen people in my family and friend network that are alive now after treatment from a cancer that was fatal in most cases 20 years ago. That’s not proof by any measure but I am certainly thankful it’s not 20 years ago.

Prostate cost nothing now in your 30s too

I can remember it from several decades ago.

It is early.

“A 60-year-old male in the US can expect to live until about age 82”

Pancreatic cancer usually is hard to detect until it’s reached an advanced stage. We really should invest more into research


Pancreatic cancer. Still quite deadly. It has been 17 years since Randy Pausch’s The Last Lecture.

https://youtu.be/ji5_MqicxSo?si=TlgWzgQ7bD3Usvu3


Steve also, correct? Wonder if it has anything to do with the chemical dumping in silicon valley.

Jeff Raskin too. Three key people at various points in the original Macintosh’s development.

There were a lot of Superfund sites in Silicon Valley.

https://www.nytimes.com/2018/03/26/lens/the-superfund-sites-...


What kind of margins does Nvidia make on silicon? AMD? I don’t think 50% is a lot in the semiconductor industry.

Immunotherapy for multiple myeloma developed in China:

“The immunotherapy developed by Legend Biotech, a company founded in China, seems to have made their cancer disappear. And after five years, it still has not returned in those patients”


Tunisia is on my short list. In addition to a lot of Roman ruins, it has been used in movie locations. eg Tatooine in Star Wars.

https://www.smithsonianmag.com/sponsored/star-wars-tunisia-f...

https://depart-travel-services.com/en/discover-the-iconic-st...


I've been to Tunisia several times since 2021.

If you like Roman ruins, here's my favorite sites that I've personally visited:

- Amphitheatre of El Jem - https://en.wikipedia.org/wiki/Amphitheatre_of_El_Jem

- Dougga - https://en.wikipedia.org/wiki/Dougga

- Bulla Regia - https://en.wikipedia.org/wiki/Bulla_Regia

While itself not an amazing Roman building, I also enjoyed going to Ksar Ghilane - https://maps.app.goo.gl/Ru5sEqEtJDEWNg3R7. There's a small touristic oasis where you ran rent a quad bike, zip over some dunes in the Sahara, and then stop at the small Roman fort. It's fun to imagine being a Roman stationed at one of the southern most outposts of the empire. It's also fun to rent a 4x4 w/ driver and drive through the desert from Douz to Ksar Ghilane.


In addition to Roman ruins, one of the best museums I've been to - the Bardo, with lots of roman mosaics.

https://en.wikipedia.org/wiki/Bardo_National_Museum_(Tunis)


Turkey is a good place to visit too, if you like ancient ruins: https://lionsinthepiazza.com/ancient-ruins-turkey-southern-c...

EV’s could take a hit in America but we’re only 17% of the global car market.


$2 trillion for that war. Next time let’s cure cancer(s).

Correct, no one said it would be easy. True we would likely not have succeeded, but millions more would be cancer survivors.


Eisenhower's "chance for peace" speech:

> Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed.

> This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children. The cost of one modern heavy bomber is this: a modern brick school in more than 30 cities. It is two electric power plants, each serving a town of 60,000 population. It is two fine, fully equipped hospitals. It is some fifty miles of concrete pavement. We pay for a single fighter with a half-million bushels of wheat. We pay for a single destroyer with new homes that could have housed more than 8,000 people. . . . This is not a way of life at all, in any true sense. Under the cloud of threatening war, it is humanity hanging from a cross of iron.


2,000,000 miles of roads @ $1,000,000 per mile.

Think of that the next time you drive through Arizona on I-40, avoiding the potholes, debris, and life-threatening disrepair.

I-40 runs a scant 2,556 miles from Barstow, CA to Benson, NC.


I always wonder how much the war would've ended faster if Bremer didn't screw up the "transition" phase. So many lives would've been spared.


Meanwhile, China is outproducing the USA in ships by 1 to 100. Add steel electronic manufacturing, robots, drones, batteries etc. to it and the 'war on terror' actually lost the USA the global dominance


Alternatively, for $2 trillion, you could probably solve cold fusion and synthesis of liquid fuels, making the Middle East's oil wealth effectively irrelevant.


Cold fusion is basically impossible according to the laws of the universe as we understand them today. You'd have to do some sort of major discovery about the fundamental physics to do cold fusion. It's unclear (and IMHO, very unlikely) this will ever happen. It's very much not a money issue, it's a "we need to wait on some Einstein to make a major discovery of an unknown nature" issue, except that we don't know if that's even possible.


That's assuming cold fusion is real.


> $2 trillion for that war. Next time let’s cure cancer(s).

Aren't there any positive tradeoffs in overthrowing the likes of Saddam Hussein?


There's a problem there. Many people reason about things by assuming that since option A is clearly bad, option B must be more desirable. But in life we often have this fun situation where we get to choose between a bad choice, and a terrible one - there is no good one.

Saddam was, without any doubt, an at-times brutal tyrant. Yet not only was Iraq vastly more stable and peaceful under his reign, but so too was the entire Mideast. That war set off a chain reaction of events that led to a complete destabilization in the Mideast and created a fertile ground for extremist groups to recruit, operate, and generally thrive.

So I don't think so. Like in most contemporary wars, the only real winners are the arms dealers, and the people getting rich off death and destruction.


> Saddam was, without any doubt, an at-times brutal tyrant. Yet not only was Iraq vastly more stable and peaceful under his reign, but so too was the entire Mideast.

Hindsight is 20/20, but as consequences go I think that making a mockery of the UN in general and it's sanctions and weapons inspection in particular was something that had far more nefarious consequences. Most of today's stability issues in the middle east are caused by Iran financing and supporting terror groups, which isn't something that Saddam Hussein would counter. Worst case scenario, Saddam's post-normalization rule would double down on this playbook. Gaddafi's fate and Israel's handling of Iran shows that this blend of terrorism is only curtailed by going after the source.


> as consequences go I think that making a mockery of the UN in general and it's sanctions and weapons inspection in particular was something that had far more nefarious consequences

Any serious observer could only agree. Colin Powell has much for which to answer, just for a start.


The problem was that he was holding Iraq together. After he fell, we ended up with a situation where there are about 1/2 as many Iraqi Christians in Sweden as there are in Iraq.

Basically, Iraq went straight to hell, and whatever minorities etc. didn't flee got murdered.

I interpret it as something along the lines of Saddam Hussein's government caring about having a strong or at least functional country enough that they only wanted to kill Kurds and Iranians.

Baathists are better than sectarian madmen, and I suspect we'll see some kind of idiot outcome in Syria as well.


> The problem was that he was holding Iraq together.

Not really. He was oppressing Iraq and ruling it with a cruel tight grip, but any regime change takes decades to normalize. You don't just replace a nation's political class overnight and expect to a) not have pushback, b) the successors having it easy or hitting the ground running.


I think the outcome was bad enough that the cruel crip didn't matter, and I suspect that we'll find that to have been the case also in Syria.

Furthermore, it's not as if though cruel grips can't grow back with another hand.


You’re saying that he was holding Iraq together in a bad way, which is true.

But he was holding it together. There might be a case for removing him, but note that nobody ever made that case without resting it on total fabrications. Because, while he was “bad” in a moral sense, there was no case for the war that could be made using the actual truth.


> any regime change takes decades to normalize

Oh come on. To whom in 2025 could you possibly expect to sell this nonsense excuse for an unbroken record of catastrophic neoconservative failure? Do you steal candy from babies also?


Yeah, like killing half a million people, creating an environment for ISIS to germinate, grow, and perform unspeakable atrocities in both that, and a neighbouring country (with a little bit of fun terrorism in Europe thrown in, but on the grand scheme of things, the moral weight of a few hundred murdered Europeans pales in comparison to what they were doing closer to home).

It's never a bad idea to create a power vacuum by overthrowing a dictatorship and then utterly fucking up your occupation and handling of the peace.

It's not clear if any invader and occupier could have handled that part well, but it is absolutely clear that the ghouls running the Bush regime were completely incapable of it. That those architects are still part of civilized society, and didn't spend the rest of their worthless lives breaking rocks with their teeth in a chain gang never fails to boil my blood. They put the lie to every principle of freedom and liberty that western democracies claim to stand for.

Similar horrors were inflicted on Libya by the Obama administration in particular and NATO in the general, but they were smart enough to not even sully their hands with making any effort to occupy and nationbuild after the fact. And guess what happened? Also ISIS and also a decade of civil war, and while it's died down a bit, there are still violent clashes between warlords and a humanitarian disaster nobody gives two shits about going on in the background.

Under Qadaffi, Libyans weren't free. But they weren't hungry, either.


Half a million dead for totally bogus reasons, and you want to try to find positive tradeoffs?


Maybe? But it destabilized the Middle East, caused the migrant crisis in Europe, the migrant crisis caused a rise in right wing movements in Europe, it caused the rise of ISIS (lots of Iraqi ex-military), ISIS was involved in the the civil war in Syria, it caused a loss of faith in the American government, created a generation of disillusioned combat vets, so on and so forth.

I really think we're still recovering from the damage caused by Bush administration.


Are we recovering? The knock-on damage you list seems to be accelerating if anything.


Fair enough!


In an alternate timeline, maybe he would have become more of a dangerous liability, but I think it would have been cheaper for the CIA to overthrow him in any case


The CIAs track record here is terrible. It basically only succeeds if there is already a viable opposition that it can hand bags of cash.

It can't create regime change out of nothing, despite what it's detractors and its own propaganda might claim.


Not much. Except for the oil companies. In any case the goal was not to make the world a better place.


We should be reaching peak coal real soon now:

https://www.iea.org/news/global-coal-demand-is-set-to-platea...


It’s really all up to China now, to build and sell as many EVs, batteries, and solar panels as they can. They have to crowd out fossil energy usage globally as a global clean energy manufacturing powerhouse.


They might have/choose to create batterie big enough to retrofit their diesel-electric haul truck first, to start at the beginning of the batteries supply chain. Not wanting to sound defeatist but that's not the easiest part.



Wow that’s interesting indeed. Thanks for the links.


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