the reason I think we have to pay attention to cancer screening in such an aggressive way is that unlike cardiovascular disease and even though we didn't really go into the pathogenesis of it today I mean I've covered this on other podcasts I'm sure you have as well it's very well understood doesn't mean we know everything I I'll happily spend 20 minutes telling you all the things I don't understand or that we don't understand as as a community but we have a pretty good sense of what's going on that's not the case in cancer it is still a really really big black box to try to understand all the different ways in which people get cancer and if you just want proof positive on this I bet you there's not a single person listening to this not one who can't tell you of at least one person they know who's been Afflicted with cancer who otherwise did everything right they didn't smoke they weren't obese they didn't have you know huge chemical carc exposures they lived a perfectly healthy life and they still got breast cancer or they still got leukemia or they still got some god- awful cancer