Search Results for "overdiagnosis"
Beware the polyp police
…e-based arguments about whether they were doing more harm than good. The main issue has been the possibility of overdiagnosis. In the case of colon cancer, because most of us will have polyps and very few of us will die from them, screening is also liable to result in overdiagnosis and overtreatment. If and when polyps are found, people may live under a dark cloud, with a pre-cancerous label for the rest of their lives. They will certainly be m…1 9/9/2013
Breast cancer and stroke screening stories that deserve careful attention
…d controlled trials underestimate the effects of mammography, but dont say why. Nor do they say anything about overdiagnosis, overtreatment, lead time bias, and length biased sampling. Finding a tumour early is necessary but not sufficient for screening to save lives. It might just mean that screen detected cancers have longer to go in their natural history with treatment than otherwise and hence survival from diagnosis could be longer without a…1 1/6/2014
NBC vastly exaggerates the potential benefits of lung cancer screening
…urther evaluation with imaging or clinical follow-up, which were predominantly done for benign disease. … Overdiagnosis and consequent overtreatment is a concern in lung cancer screening. The 1% to 2.7% prevalence of unrecognized lung cancer suggests a preclinical pool of lung cancer in high-risk populations. The clinical significance of these tumors is uncertain, but patients with lung cancer typically receive treatment, resulting in harm…12/10/2013
The potential harms of screening – seen this time in lung cancer screening
…there be harms from screening for cancer? Maybe the study published this week in JAMA Internal Medicine, “Overdiagnosis in Low-Dose Computed Tomography Screening for Lung Cancer,” will make some of the potential harms a little more clear. The analysis shows that nearly 20% of all lung cancers found by CT screening seemed to be harmless (indolent is the term the researchers used). The researchers wrote: “These patients may underg…10/30/2012
Were AP and AFP reporting on the same Lancet mammography paper?
…sten Jorgensen, a researcher at the Nordic Cochrane Centre in Copenhagen who has previously published papers on overdiagnosis. “It’s important they have at least acknowledged screening causes substantial harms,” he said, adding that countries should now re-evaluate their own programs. In the United States, a government-appointed task force recommends women at average risk of cancer get mammograms every two years starting at age…4 1/12/2011
"Simple blood test" – cancer breakthrough or nightmare?
…diagnosis is a double-edged sword. While it has the potential to help some, it always has a hidden side-effect: overdiagnosis, the detection of abnormalities that are not destined to ever bother people in their lifetime. Becoming a patient unnecessarily has real human costs. There’s the anxiety of being told you are somehow not healthy. There’s the problem that getting a diagnosis may affect your ability to get health insurance. There…10/7/2011
Thoughtful analysis of the USPSTF and prostate cancer screening
…redible, but showed only a small absolute survival benefit. This benefit must be balanced against the harms of overdiagnosis–finding cancers that would never cause clinical problems during a man’s lifetime–and the resulting overtreatment, which can lead to urinary, bowel, and sexual dysfunction. Unfortunately, we cannot confidently identify the “overdiagnosed” cancers found with screening, so most men will undergo…2/10/2011
Pioneer Press publishes my call for balance in cancer screening messages
…Here’s Why”) wrote about mammography in a medical journal: “The question is no longer whether overdiagnosis occurs, but how often it occurs.” He included the following table to explain the tradeoffs of harms and benefits (debits and credits) – and this was for 50-year old women, for whom the evidence of benefit is stronger than it is for those in their 40s. Welch explains, “The benefit of breast cancer scree…4/30/2012
Analysis of two Annals papers on benefits of mammography in younger women
…iopsy results, radiation exposure, false-negative results and false reassurance, pain related to the procedure, overdiagnosis (that is, diagnosis of tumors that are of no threat), and overtreatment. False-positive results are the most common and easily quantifiable harm. On the basis of statistics specific to U.S. practice patterns, about half of women getting an annual mammogram for 10 years starting at age 40 years will have at least 1 false-po…6/21/2010
NY Daily News begins second decade of evading evidence on PSA screening
…cial like this plays to our fears and prejudices. … Prostate cancer screening has resulted in substantial overdiagnosis and in unnecessary treatment. It may have saved relatively few lives. … The benefits of prostate cancer screening are still open to question. This means that informed or shared decision making should be done using the data now available before screening is performed. Some of the confusion of prostate cancer screening…6/11/2011
Heart screening tests that should be screened more closely by consumers
…d hypochondriacs. In 1673, Molière pictured Fleurant, a money-hungry apothecary, as the supplier of unicorn’s horn to the “Imaginary Invalid”. Now, who will write the “Healthy unwitting”? We must recognize the discrepancy between the expected and the actual impact of screening in real life settings. Disease mongering and overdiagnosis are a source of harm. http://en.wikipedia.org/wiki/The_Imaginary_Invalid“…2 10/17/2013
Omega-3 fatty acids & prostate cancer: study and stories off-base
…the study were diagnosed based on an abnormal PSA test result, which is known to markedly increase the risk of overdiagnosis of prostate cancer–that is, finding cancers that would never cause harm during a mans lifetime. Overall, only 156 (18.7%) of cancers were high-grade (potentially aggressive). Furthermore, there were just 17 more high-grade cancers among men in the highest quartile of O3FA levels compared to the lowest quartile. Ev…1/5/2015
Alan Cassels guest blog post: PSA test – good myths die hard
…e kinds of opinion columns and stories will continue to be produced, and the test, called the Poster Child for Overdiagnosis will continue to be offered to men. There is one incontrovertible fact in this story: That prostate cancer kills about 30,000 men a year. Everyone wishes there was a better test, but instead of dumping on the USPSTF and disagreeing with their evidence-based assessment of the test perhaps the urologists could admit that…8 2/6/2013
Five year survival rates can mislead – message to medical educators, medical journals, journalists and the public
…lier; this alone leads to higher survival at five years evenwhen patients do not live any longer. The second is overdiagnosis. Screening detects abnormalities that meet the pathological definition of cancer but that will never progress to cause symptoms or death (non-progressive or slow growing cancers). The higher the number of overdiagnosed patients, the higher the survival rate. In the US a larger proportion of men are screened by prostate spe…1/6/2012
Stop inappropriate, expensive & perhaps even unethical radical therapies for a condition that by itself does not kill
…re are ASCUS cells – or “atypical squamous cells of unknown significance.” Gleason 6 cells in the prostate cancer field have been called “adenosis.” They’ve been called IDLE – indolent lesions of epithelial origin. Whatever these cells are called, one practical goal for now is to educate men about the harms of overdiagnosis and overtreatment and offer active surveillance as a treatment option….