Health News Review
  • Jul 29 2013

    Cautions on cancer screening, overdiagnosis and overtreatment

    …;In March 2012, the National Cancer Institute convened a meeting to evaluate the problem of “overdiagnosis,” which occurs when tumors are detected that, if left unattended, would not become clinically apparent or cause death. Overdiagnosis, if not recognized, generally leads to overtreatment. This Viewpoint summarizes the recommendations from a working group formed to develop a strategy to improve the current approach to cancer screening and prev…

  • Jun 1 2012

    BMJ feature – Preventing Overdiagnosis: how to stop harming the healthy

    “Preventing overdiagnosis: how to stop harming the healthy,” is a feature in this week’s BMJ by Ray Moynihan, Jenny Doust and David Henry. I won’t try to recapture the entire piece in this blog because you should read it yourself. But here are section headings: Screening detected overdiagnosis Increasingly sensitive tests Incidentalomas Excessively widened definitions (of disease) Examples of overdiagnosis Asthma—Can…

  • Nov 23 2012

    Roundup of some reactions to NEJM mammography overdiagnosis analysis

    …f 50 Option 3: Do Not Recommend Screening Mammography Dr. Gil Welch, one of the authors of the “Effect of Three Decades…” analysis, wrote a New York Times opinion piece, “Cancer Survivor or Victim of Overdiagnosis?” in which he summarized: “So here is what we now know: the mortality benefit of mammography is much smaller, and the harm of overdiagnosis much larger, than has been previously recognized. But to b…

  • Jan 22 2013

    UK citizen’s jury advises on communication about the benefits and harms of breast screening

    …f 50 and 70 to undergo a mammogram every three years. The current invitation letters and accompanying leaflets have been heavily criticised for failing to mention potential harms of breast screening, in particular the risk of overdiagnosis and overtreatment (http://www.bmj.com/content/338/bmj.b86). In response to this criticism, Sir Michael Richards, National Cancer Director for the NHS, asked eminent epidemiologist Sir Michael Marmot to chair an…

  • Apr 23 2010

    Overdiagnosis in cancer & role of shared decision-making

    Gil Welch and Bill Black of Dartmouth address cancer overdiagnosis in a new review article in the Journal of the National Cancer Institute. Excerpt from the abstract: “We estimated the magnitude of overdiagnosis from randomized trials: about 25% of mammographically detected breast cancers, 50% of chest x-ray and/or sputum-detected lung cancers, and 60% of prostate-specific antigen-detected prostate cancers. We also review data from observ…

  • Apr 20 2012

    2 pieces on overdiagnosis – including self-diagnosis

    I’m in my element, among 600 or so attendees at the Association of Health Care Journalists’ annual conference in Atlanta.  But, as a result, I only have time today to point you to a couple of interesting pieces: A Reuters special report on how an aggressive campaign for esophageal cancer screening feeds overdiagnosis debate. On the Washington Post’s Wonkblog, “How WebMD convinces us we’re dying.” …

  • Jan 19 2012

    The Naked Doctor: profiling overdiagnosis and overtreatment

    We’ve long been admirers of the Croakey blog, run by Melissa Sweet in Australia. Now Croakey has a new project called The Naked Doctor. The site says: Naked Doctor aims to encourage discussion and awareness of the opportunities to do more for health by doing less. It is a compilation of articles, books and other works that highlight overdiagnosis and overtreatment. It is a project of Dr Justin Coleman, a GP who works in Aboriginal and Torr…

  • Jul 26 2010

    New data raising concerns over overdiagnosis & overtreatment of prostate cancer

    … the fact that PSA level, the current biomarker, is not a sufficient basis for treatment decisions. Without the ability to distinguish indolent from aggressive cancers, lowering the biopsy threshold might increase the risk of overdiagnosis and overtreatment. Here’s a Reuters summary of the article. WebMD’s is here. Katie Hobson on the WSJ Health Blog offered good perspective. …

  • Oct 22 2013

    When doctors don’t discuss harms of screening tests with patients

    …n aged 50-69 years, a population with the highest exposure to screening programs. Their summary: Most participants in our sample who underwent routine cancer screening reported that their physicians did not tell them about overdiagnosis and overtreatment. The few who received information about overtreatment had unrealistic beliefs about the extent of that risk. The large number of uninformed patients might be explained by a large number of phy…

  • Feb 25 2014

    Thyroid cancer: “not an epidemic of disease but an epidemic of diagnosis”

    A paper in the journal JAMA Otolaryngology – Head & Neck Surgery, “Current Thyroid Cancer Trends in the United States,” addresses overdiagnosis of thyroid cancer.  The authors report a tripling of incidence over the past 40 years, but a stable death rate.  The authors write that nearly all of the increase was in less aggressive or small tumors that may never cause harm: “…it is not an epidemic of disease but rat…




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