Overdiagnosis

Cancer screening is most useful in detecting slowly progressing cancers but can cause overdiagnosis if very slow or non-progressive cancers are detected.

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Overdiagnosis can inflate survival rates without any actual health benefits.

Overdiagnosis

Overdiagnosis refers to the identification of diseases or conditions that, while accurately diagnosed, will not cause symptoms or lead to death within a patient's anticipated lifespan. This phenomenon can inadvertently convert healthy individuals into patients, possibly exposing them to treatments that may be unnecessary or even harmful.

Definition and Causes

Overdiagnosis is characterized by the correct but unnecessary diagnosis of a "disease". It often arises as a consequence of:

• Screening for early disease manifestations, which while intended to save lives, can also detect inconsequential abnormalities.
• Biological variability, as more screenings tend to yield more incidental findings. However, deciding the right course of action for these findings, whether it's no intervention, watchful waiting, or active intervention, can be challenging.

Relevance of Diagnosis

A diagnosis is considered overdiagnosis when it's both accurate and irrelevant. This irrelevance can be due to:

• Absence of available treatment.
• Lack of necessity for treatment.
• Patient preference against treatment.

While some believe that the term "overdiagnosis" might not be the most appropriate, suggesting "overtreatment" instead, it's important to note that overdiagnosis precedes overtreatment.

Detection of Overdiagnosis

Identifying overdiagnosis in an individual is challenging, mainly because:

• Most diagnosed individuals undergo treatment.
• It's impossible to confirm overdiagnosis during a patient's life. The only certainty is when an untreated individual never exhibits disease symptoms and dies from another cause.

However, there are methods to infer overdiagnosis:

• Examining populations, especially when there's an increase in testing and disease diagnosis but stable rates of the disease's feared outcomes (e.g., death).
• Evidence from randomized trials for screening tests meant for detecting pre-clinical diseases. A sustained excess of diagnosed diseases in the test group post-trial completion provides strong evidence of overdiagnosis.

Relation to Cancer Screening

The concept of overdiagnosis is deeply tied to cancer screening, which involves evaluating asymptomatic patients to detect early cancer stages. One primary risk of such screening is overdiagnosis, leading to the detection of abnormalities that, while pathologically defined as cancerous, won't progress to cause symptoms or lead to death within a typical lifespan.

See Also

• Screening (medicine)
• Overtreatment
• Watchful waiting

See also

• Disease mongering
• False positive
• Medicalization
• Interventionism (medicine)
• Patient education
• Schooliosis
• Screening (medicine)

Overdiagnosis Resources
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