Come as You Are: Difference between revisions

🦠 '''8 – The runaway cell: new ways to address the killer that is cancer.''' In 2011, the National Lung Screening Trial randomized more than 53,000 high-risk smokers to three annual low-dose CT scans versus chest X-rays and cut lung-cancer mortality by roughly 20%, with about three fewer deaths per 1,000 people screened over ~7 years and a 6.7% drop in all-cause mortality. Not all screens help equally: the U.S. PLCO trial enrolled ~155,000 people from 1993 to 2001 and, amid heavy PSA “contamination” in the control arm, showed no prostate-cancer mortality benefit; meanwhile, the ERSPC trial reported a 20–21% prostate-cancer mortality reduction with routine PSA testing at the cost of overdiagnosis. Colorectal screening offers multiple lanes: colonoscopy quality is tracked with adenoma detection rate benchmarks, while a 2014 NEJM study validated a multitarget stool-DNA test that combines a hemoglobin immunoassay with assays for KRAS mutations and methylation of NDRG4 and BMP3. Guidelines have shifted screening earlier—into the mid-40s—because incidence patterns changed, and flexible pathways (FIT, stool DNA, sigmoidoscopy, colonoscopy) let people match preference to risk. The thread through all of this is calibrated screening: hit the cancers where mortality moves and avoid tests that mainly uncover harmless disease. Layer in exposure control—don’t smoke, manage weight and insulin resistance, limit alcohol—and the baseline risk drops before any scan. Treatment is still improving, but the biggest wins come from catching lethal cancers sooner and avoiding the ones that never needed treatment. Make cancer a probability game you can influence—choose screenings with proven mortality benefit and reduce exposures that feed tumor biology. Optimize expected value by pairing high-yield tests (by age and risk) with long-horizon habits so fewer dangerous cancers gain a foothold.

 

 

== Background & reception ==

👍 '''Praise'''. In The Guardian, Van Badham praised the book’s rare merger of pop science and sexual self-help “in prose that’s not insufferably twee,” adding that it offers “hard facts on the science of arousal and desire” in a friendly way (27 April 2015).<ref>{{cite news |title='You're normal!' is science's battle cry in the fight for sexual liberation |url=https://www.theguardian.com/commentisfree/2015/apr/28/youre-normal-is-sciences-battle-cry-in-the-fight-for-sexual-liberation |work=The Guardian |date=27 April 2015 |access-date=19 October 2025}}</ref> WBUR (Boston’s NPR newsroom) highlighted the book’s myth-busting approach and predicted it would be a pivotal read for many (13 March 2015).<ref>{{cite news |title='Come As You Are': Book Explores Old Lies And New Science On Women And Sex |url=https://www.wbur.org/news/2015/03/13/come-as-you-are-women-sex |work=WBUR News |date=13 March 2015 |access-date=19 October 2025 |last=Goldberg |first=Carey}}</ref> Salon’s interview with Nagoski called it a rare sex-advice book that “actually has it” — lasting value beyond quick fixes (6 March 2015).<ref>{{cite news |title=Forget female Viagra: This new book dismantles stubborn myths about women and sexual desire |url=https://www.salon.com/2015/03/06/forget_female_viagra_this_new_book_dismantles_stubborn_myths_about_women_and_sexual_desire/ |work=Salon |date=6 March 2015 |access-date=19 October 2025 |last=Clark-Flory |first=Tracy}}</ref>