Risk of overdiagnosis in cancer screenings is not being explained

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A survey finds that most patients are not being told about the possibility of overdiagnosis and overtreatment as a result of cancer screenings.

Cancer screenings can find treatable disease at an earlier stage, but they can also detect cancers that will never progress to cause symptoms. Odette Wegwarth, PhD, and Gerd Gigerenzer, PhD, of the Max Planck Institute for Human Development in Berlin, Germany, explained that detecting these early, slow-growing cancers can lead to unnecessary surgery, chemotherapy, and radiation. They stated that for every 2,000 women who undergo mammography throughout 10 years, one less dies of breast cancer. However, approximately 10 diagnoses of pseudodisease are made and patients undergo unnecessary breast cancer treatments.

The research team conducted an online survey of 317 US men and women age 50 to 69 years to find out how many patients had been informed of overdiagnosis and overtreatment by their physicians. The patients were also asked how much overdiagnosis they would tolerate when deciding whether to start or continue screening.

Of the group, 9.5% of the study participants (n=30) reported their physicians had told them about the possibility of overdiagnosis and overtreatment. About half (51%) of the participants reported that they were unprepared to start a screening that results in more than one overtreated person per one life saved from cancer death. However, nearly 59% reported they would continue the cancer screening they receive regularly even if they learned that the test results in 10 overtreated people per one life saved from cancer death.

"The results of the present study indicate that physicians' counseling on screening does not meet patients' standards," the study concluded. The study was published in JAMA Internal Medicine (2013; doi:10.1001/jamainternmed.2013.10363).

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