Overdiagnosis in cancer - PubMed (original) (raw)
Review
. 2010 May 5;102(9):605-13.
doi: 10.1093/jnci/djq099. Epub 2010 Apr 22.
Affiliations
- PMID: 20413742
- DOI: 10.1093/jnci/djq099
Review
Overdiagnosis in cancer
H Gilbert Welch et al. J Natl Cancer Inst. 2010.
Abstract
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.
Comment in
- Solving the overdiagnosis dilemma.
Esserman L, Thompson I. Esserman L, et al. J Natl Cancer Inst. 2010 May 5;102(9):582-3. doi: 10.1093/jnci/djq119. Epub 2010 Apr 22. J Natl Cancer Inst. 2010. PMID: 20413743 No abstract available. - Re: Overdiagnosis in cancer.
Henson DE, Siddiqui H, Schwartz AM. Henson DE, et al. J Natl Cancer Inst. 2010 Dec 1;102(23):1809-10; author reply 1810-1. doi: 10.1093/jnci/djq410. Epub 2010 Oct 11. J Natl Cancer Inst. 2010. PMID: 20937990 No abstract available. - Less is more: not "going the distance" and why.
Harris R, Kinsinger LS. Harris R, et al. J Natl Cancer Inst. 2011 Dec 7;103(23):1726-8. doi: 10.1093/jnci/djr446. Epub 2011 Nov 9. J Natl Cancer Inst. 2011. PMID: 22076286 No abstract available.
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