Overdiagnosis in cancer.
نویسندگان
چکیده
This article summarizes the phenomenon of cancer overdiagnosis-the diagnosis of a "cancer" that would otherwise not go on to cause symptoms or death. We describe the two prerequisites for cancer overdiagnosis to occur: the existence of a silent disease reservoir and activities leading to its detection (particularly cancer screening). 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. Equally important, researchers need to work to develop better estimates of the magnitude of overdiagnosis and develop clinical strategies to help minimize it.
منابع مشابه
Difficulties in Diagnosis of Hemophagocytic Lymphohistocytosis: Overdiagnosis or Underdiagnosis A Case Report
متن کامل
Overdiagnosis of gastric cancer by endoscopic screening
Gastric cancer screening using endoscopy has recently spread in Eastern Asian countries showing increasing evidence of its effectiveness. However, despite the benefits of endoscopic screening for gastric cancer, its major harms include infection, complications, false-negative results, false-positive results, and overdiagnosis. The most serious harm of endoscopic screening is overdiagnosis and t...
متن کاملEstimation of Overdiagnosis in Breast Cancer Screening
I. Summary The benefit of breast cancer (BC) screening with mammography has been demonstrated by randomized controlled trials (RCTs). However, there is a growing concern about the harms of screening, in particular the problem of overdiagnosis. It occurs when screening detects a breast cancer that would not have presented clinically in the woman's lifetime in the absence of screening. Overdiagno...
متن کاملOverestimating Overdiagnosis in Breast Cancer Screening
Overdiagnosis in breast cancer has been a focus of increasing concern with wide ranges of calculations made indirectly through the study of prospective randomized trials and analyses of large registries. While most admit that some degree of overdiagnosis is inherent with ductal carcinoma in situ (DCIS), the rate of overdiagnosis with invasive disease is highly controversial. Although it is gene...
متن کاملResponses to Overdiagnosis in Thyroid Cancer Screening among Korean Women
PURPOSE Communicating the harms and benefits of thyroid screening is necessary to help individuals decide on whether or not to undergo thyroid cancer screening. This study was conducted to assess changes in thyroid cancer screening intention in response to receiving information about overdiagnosis and to determine factors with the greatest influence thereon. MATERIALS AND METHODS Data were ac...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Journal of the National Cancer Institute
دوره 102 9 شماره
صفحات -
تاریخ انتشار 2010