In 2011, BreastScreen Australia celebrated 20 years of mammographic screening for breast cancer in Australia. There has been a reduction in mortality from breast cancer over the last two decades, coincident with mammographic screening. However, there are concerns that mammographic screening may result in overdiagnosis of breast cancer and that the reduction in mortality from breast cancer is th...

OBJECTIVE To determine the optimal method for quantifying and monitoring overdiagnosis in cancer screening over time. DESIGN Systematic review of primary research studies of any design that quantified overdiagnosis from screening for nine types of cancer. We used explicit criteria to critically appraise individual studies and assess strength of the body of evidence for each study design (doub...

In this issue of the Journal, Etzioni et al. (1) suggest a novel approach to estimating overdiagnosis in breast cancer. However, there is a key assumption in their method regarding the nature of overdiagnosis that is unlikely to hold and leads to an underestimate of the overdiagnosis rate. To understand this assumption, we need to go back to basic definitions. Lead time is the time from detecti...

I. Jørgensen KJ, Gøtzsche PC. Presentation on web sites of possible benefits and harms from screening for breast cancer: cross sectional study. BMJ 2004;328:148-51. II. Jørgensen KJ, Gøtzsche PC. Content of invitations for publicly funded screening mammography. BMJ 2006;332:538-541. III. Jørgensen KJ, Zahl PH, Gøtzsche PC. Breast cancer mortality in organised mammography screening in Denmark. A...

Defining, estimating, communicating about, and dealing with overdiagnosis is challenging. One reason for this because a complex phenomenon. In article we try to show that the complexity can be analysed addressed in terms of three perspectives, i.e., person, professional, population. Individuals are informed about based on population-based estimates. These estimates depend professionals' concept...