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.
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.
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