Standard definition for 'overdiagnosis' could better patient decisions about cancer screening
Authors of a June 26 editorial in the Annals of Internal Medicine advocated for a standard definition of "overdiagnosis" regarding cancer screenings, arguing poor understanding of the term is a threat that exposes patients to unnecessary treatments.
“The toll of inadequate health care is well-substantiated, but recognition is mounting that ‘too much’ is also possible,” wrote lead author Louise Davies, MD, MS, from the Geisel School of Medicine at Dartmouth and Dartmouth Institute for Health Policy and Clinical Practice, and colleagues.
“Overdiagnosis represents one harm of too much medicine, but the concept can be confusing: It is often conflated with related harms (such as overtreatment, misclassification, false-positive results and overdetection) and is difficult to measure because it cannot be directly observed.”
Davies and colleagues define "overdiagnosis" as "the detection of a (histologically confirmed) cancer through screening that would not otherwise have been diagnosed in a person’s lifetime had screening not been done."
A fear of cancer causes many people to be screened despite a possibility the cancer may be benign/ But the problem of "overdiagnosis" is more significant, the authors explained.
"Recent work to understand the U.S. public’s view of low-value care—a concept related to overdiagnosis—showed that most of the healthy respondents had difficulty envisioning how healthcare, particularly testing, could be harmful," the authors wrote.
When estimating overdiagnosis, the authors recommended that physicians should consider a patient's uncertainties about life expectancy and discuss benefits and harms of screening.
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.