erictopol.substack.com/p/dawn-of-a-new-era-of-primary-prevention
2 corrections found
which, in over 90% of cases, is only currently diagnosed at late, metastatic stages.
U.S. cancer registry data do not show that over 90% of pancreatic cancers are metastatic at diagnosis. SEER reports about 51% are distant/metastatic at diagnosis, with another 28% regional and 15% localized.
Full reasoning
The article overstates how often pancreatic cancer is metastatic when first diagnosed.
According to the National Cancer Institute's SEER Cancer Stat Facts, pancreatic cancer cases are diagnosed by stage approximately as follows:
- 15% localized
- 28% regional
- 51% distant (metastatic)
- 5% unknown
That means about 51%, not over 90%, are metastatic at diagnosis. Even if the author intended a broader concept of "late stage" that included both regional + distant disease, the SEER figures still total about 79%, not more than 90%.
A separate American Family Physician review likewise states that only 12% of patients are diagnosed with localized disease, which still does not imply that over 90% are metastatic; it means most are not localized, a different claim.
So the specific statement that pancreatic cancer is diagnosed in "over 90% of cases" at "late, metastatic stages" is not supported by U.S. stage-at-diagnosis data.
2 sources
- SEER Cancer Stat Facts: Pancreatic Cancer
Percent of Cases by Stage at Diagnosis: Localized 15%; Regional 28%; Distant 51%; Unknown 5%.
- Pancreatic Cancer: Rapid Evidence Review | American Family Physician
Only 12% of patients will be staged with localized disease at the time of diagnosis... the five-year survival rate is 44% for local disease, 16% for regional disease, and 3% for metastatic disease.
we have not had any clinical way to assess the immune system until these clocks have arrived
Clinicians have long had established ways to assess immune function. Standard immune evaluation predates organ clocks and includes tests such as immunoglobulins, lymphocyte subset counts, complement testing, and phagocytic-function assays.
Full reasoning
This claim is too absolute. Clinical assessment of the immune system did not begin with organ clocks. Long before epigenetic or proteomic clocks, clinicians already had established laboratory and functional tests to evaluate immune status.
For example, standard clinical workups for suspected immunodeficiency include:
- Quantitative immunoglobulins
- B- and T-lymphocyte counts / flow cytometry
- Lymphocyte stimulation assays
- Complement component measurements and hemolytic assays
- Phagocytic-function testing
Those tests are routinely used in clinical immunology and are explicitly described in major clinical references. Epigenetic immune-age clocks may add a new kind of aging-related risk signal, but they are not the first clinical way to assess the immune system.
2 sources
- Immunodeficiency - StatPearls - NCBI Bookshelf
The immunological investigation of a patient with immunodeficiency includes the assessment of immunoglobulins... B and T-lymphocyte counts, lymphocyte stimulation assays, quantification of components of the complement system, and phagocytic activity.
- Approach to the Patient With Suspected Immunodeficiency - Merck Manual Professional Edition
Evaluation includes B-cell quantification via flow cytometry, T-cell receptor and signal transduction assays, assays for phagocytic cell defects, and measurement of levels of specific complement components.