Overdiagnosis in cancer & role of shared decision-making

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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 observational studies and population-based cancer statistics suggesting overdiagnosis in computed tomography-detected lung cancer, neuroblastoma, thyroid cancer, melanoma, and kidney cancer. To address the problem, patients must be adequately informed of the nature and the magnitude of the trade-off involved with early cancer detection.”

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Greg Pawelski

April 25, 2010 at 1:48 pm

American Cancer Society’s Dr. Len Lichtenfeld feels that no one wants to be diagnosed with cancer and no one wants to be treated unnecessarily for cancer. Yes, there are cancers that are diagnosed that will never cause harm. But to suggest that in some way we can accurately tell the difference isn’t where we are today.