I came across Vinay Prasad’s podcast conversation with Gilbert Welch where, among other things, they touched on the ”barnyard pen of cancers”. This is a proposition by Hinman (inspired by Crile) to classify cancers and into turtles, rabbits and birds. In “The Hypothetical Rabbit” Michael W. Kattan explained it as follows:

“Turtles are patients with very slow growing disease. Their disease grows so slowly that they need not be diagnosed, for the disease will never spread to the point of causing problems within the patient’s lifetime. A turtle will die of another cause, not prostate cancer.

At the other extreme is the bird. The bird has been diagnosed too late to have impact on the disease. It has already spread and cannot be meaningfully slowed down, to the point where the patient is likely to die of his prostate cancer. For the opposite reason as the turtle, the bird is similarly not helped very much by a diagnosis of prostate cancer since it is already too late to stop the disease.

The rabbit sits in the sweet spot. The rabbit is the man with prostate cancer who needs to be diagnosed (his disease spreads faster than that of the turtle and indeed poses a threat to his life), yet the disease is still curable (unlike the disease borne of the bird).”

For screening purposes one would ideally look for “rabbits”. I am wondering if you know any publications that looked at quantifying these ”rabbits” with the help of e.g. TCGA, PanCancer Atlas, Human Protein Atlas or the CPTAC?