Health News Review
  • Feb 10 2011

    Pioneer Press publishes my call for balance in cancer screening messages

    …uch promotions. Dartmouth’s Dr. Gil Welch (author of “Should I Be Tested For Cancer? Maybe Not, And 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 …

  • Oct 7 2011

    Thoughtful analysis of the USPSTF and prostate cancer screening

    …reening in the control group. The validity of the negative PLCO results is uncertain. The ERSPC study was more credible, 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 c…

  • Oct 9 2013

    Beware the polyp police

    … most-studied and widely-used screening programs (for breast and prostate cancer, for instance) have faced evidence-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, peop…

  • Sep 15 2014

    USA Today story shows lack of awareness of debate over pre-diabetes classification

    … pre-diabetes does not mean that you will develop diabetes. In fact, of 100 people like you, fewer than 50 are likely to develop diabetes in the next 10 years.”  And it has an entire section on “Harms and risks of overdiagnosis.”  Excerpt of that section: “There is a hazard in creating a pre-disease associated with a disease such as type 2 diabetes, which is itself little more than a risk factor. The biochemical diagnosis …

  • Oct 3 2012

    9-part series on over-diagnosis

    Ray Moynihan, a terrific health care journalist who is now pursuing his PhD on overdiagnosis and working as a Senior Research Fellow at Bond University in Australia, kicks off the first of a nine-part series, “Over-diagnosis Epidemic” on TheConversation.edu.au website. The first part is an introduction, “Preventing over-diagnosis:  how to stop harming the healthy.” Other colleagues author the subsequent parts in the serie…

  • Oct 12 2010

    Screening madness & multiple meds in the elderly

    This week’s Journal of the American Medical Association published a paper, “Cancer Screening Among Patients With Advanced Cancer,” that concludes: “A sizeable proportion of patients with advanced cancer continue to undergo cancer screening tests that do not have a meaningful likelihood of providing benefit.” The authors write that this “adds to the mounting concern about overdiagnosis.” A “Clinic…

  • Feb 4 2014

    My weekly fix from Richard Lehman’s journal review blog

    Jut a few gems from the February 3 edition: “Oh great. Another phase 2 study of a pricey monoclonal antibody to address the “epidemic of osteoporosis,” i.e. a pharma-driven epidemic of overdiagnosis in older women. With a nice surrogate end point: bone mineral density, which bears an oblique relationship to fracture risk. And, in a market crowded with competing cheap agents, a placebo comparator.” “The editor of the NEJM, Jeff…

  • Jun 11 2011

    Heart screening tests that should be screened more closely by consumers

    …“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“ …

  • Aug 9 2011

    TheNNT on lung cancer CT

    …tance in their attempts to quit smoking. They should know the number of patients needed to screen to avoid one lung-cancer death, the limited amount of information that can be gained from one screening test, the potential for overdiagnosis and other harms, and the reduction in the risk of lung cancer after smoking cessation. The NLST investigators report newly proven benefits to balance against harms and costs, so that physicians and patients can…

  • Oct 26 2011

    British breast cancer screening now under independent review

    …ets exaggerated benefits and did not spell out the risks. Journals showed a reputable and growing body of international opinion acknowledging that breast cancer screening was not as good as used to be thought. The distress of overdiagnosis and decision making when finding lesions that might (or might not) be cancer that might (or might not) require mutilating surgery is increasingly being exposed. The oft repeated statement that “1400 lives…




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