{"entity":{"id":"idea-prev-modern-autopsy-reservoir-studies","kind":"idea","name":"Modern autopsy studies to measure how much silent cancer people carry","aka":[],"tldr":"Autopsy studies decades ago found hidden prostate, thyroid and breast cancers in people who died of other causes, but they pre-date modern pathology. Repeating them with whole-body imaging and standardised histology would measure the reservoir of harmless cancer that every overdiagnosis estimate depends on.","summary":"Overdiagnosis estimates depend on knowing the prevalence of indolent disease, yet the data is decades old and pre-dates modern pathology. Propose systematic autopsy series with whole-body imaging and standardised histology across ages and populations, quantifying the reservoir for prostate, thyroid, breast, kidney, lung and pancreas.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Overdiagnosis and false alarms): Welch & Black, Overdiagnosis in cancer (JNCI 2010)","url":"https://doi.org/10.1093/jnci/djq099"}],"tags":[],"related":[],"cancers":["prostate","thyroid"],"sections":["early-detection"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-overdiagnosis"],"keyPapers":["paper-welch-j-natl-cancer-inst"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Modern reservoir estimates show at least 30% prevalence of indolent cancers in adults over 60 for several organs, changing screening threshold calculations.","rationale":"MCED and imaging screening will find these lesions; we need to know how many there are before deciding what to call them.","test":"Fund 2,000 autopsies across five countries.","maturity":"speculative","actor":"research","cost":"medium","horizonYears":3},"route":"/ideas/idea-prev-modern-autopsy-reservoir-studies/","neighbours":{"cancer":[{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"},{"id":"thyroid","kind":"cancer","name":"Thyroid cancer","route":"/cancers/thyroid/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"bottleneck":[{"id":"b-overdiagnosis","kind":"bottleneck","name":"Overdiagnosis and false alarms","route":"/bottlenecks/b-overdiagnosis/"}],"paper":[{"id":"paper-welch-j-natl-cancer-inst","kind":"paper","name":"Overdiagnosis in cancer","route":"/key-papers/paper-welch-j-natl-cancer-inst/"}]}}