Blaming overdiagnosis of cancer on ‘irrational exuberance’: Are we too concerned about early detection?

| | October 11, 2019
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Even though overall mortality from cancer is falling, the overall incidence is rising. The declines in lung, stomach, cervical, and colorectal cancers have been more than offset by a rise in breast, prostate, thyroid, kidney, and melanoma skin cancers.

Why are more people being told they have these cancers? Blame that on overdiagnosis — the diagnosis of cancers not destined to cause symptoms or death. Overdiagnosis is not a purposeful act; it is an unfortunate side effect of our irrational exuberance for early detection.

Early detection is always a trade-off between benefits and harms. It is influenced by a variety of factors: the biology of the disease, who is screened, how are they tested, and what happens following abnormal tests. The trade-off is most favorable in highly selected settings: individuals at genuinely high risk for cancer (think cigarette smokers) served by organized screening programs that are very attentive to minimizing overdiagnosis and false alarms.

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The problem is in the leap of faith: Early detection is increasingly seen as the default solution for all cancer — and, more broadly, disease in general.

Read full, original post: Blame rising cancer overdiagnosis on ‘irrational exuberance’ for early detection

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