Pouring cold water on precision medicine

Precision medicine became a buzzword this year after President Barack Obama said in his State of the Union address in late January 2015 that he was launching a precision medicine program. The so-called precision medicine refers to connecting the biological information of individuals with medical information to achieve the purpose of accurate diagnosis and precise treatment. Many domestic experts seem to have found a life-saving straw or panacea, advocating at conferences and meetings, even to the extent of mania, and even derived from precision surgery, precision radiotherapy, etc.; the strangest thing is that the central media also joined the ranks, and the government also intends to invest a large amount of research funds into it, as if not talking about precision medicine are embarrassed to say hello to others, the whole country has been involved in another big steel-making It seems that the whole nation has been involved in another great steel-making movement, so, in the middle of the summer, pour some cold water on the precision medicine of tumor. Liu Baodong, Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, first of all, from the etiology and pathology of tumor, besides the biological factors, it is also related to the environment and living habits. The human genome project has been completed for several years without bringing any surprise to the clinic. Secondly, in terms of diagnosis and treatment of tumors, “precision” has always been the goal of efforts for tumors themselves, and Chinese medicine has reached a perfect level of differentiation and treatment. Therefore, the emergence of precision medicine is not an innovation of Western medicine, nor is it a discipline parallel to clinical medicine, but the ultimate goal of clinical medicine. Once again, from the current rise of molecularly targeted tumor drugs, it is true that they have brought survival benefits to some tumor patients, but the ensuing drug resistance, and even the rebound effect after stopping the drugs, has increased the economic burden of families and society. The original intention of the U.S. precision medicine program may be to reduce the burden of health care insurance, but in China, the low rate and reliability of genetic testing has led to the unregulated use of molecular targeted drug therapy. Many foreign pharmaceutical companies have taken the opportunity to enter China’s huge medical market by conducting phase III clinical studies to pave the way for opening up the market. Therefore, precision medicine is also suspected of commercial hype. Finally, from the results of 40 years of human struggle with cancer, 35% of the reasons for longer cancer survival are attributed to early diagnosis (including screening), 23% are lifestyle changes, others account for 22%, and only 20% are related to therapeutic advances (including surgery, chemotherapy, and molecular targeted drug therapy). Therefore, although biomedicine can boost GDP, at the national level, in addition to guiding biomedical innovation, more attention should be paid to disease prevention; I advocate science education on disease prevention and health care, but suggest that all media columns on disease diagnosis and treatment should be cancelled, because such programs seem to become a huge advertisement, which makes people with poor discernment skills live in anxiety, and even the emergence of China Another phenomenon of over-medication, unique to China. Without going into conspiracy theories about whether it is similar to the U.S. Star Wars program that brought down the former Soviet Union, the precision medicine program, although it will not bring down China, will at least waste a lot of human and material resources, and if it is invested in preventive medicine, it will bring sustainable development to a healthy China, which is a long-term systemic project that will not be effective in the short term.