Is cancer overdiagnosis a problem?

Is it possible to overdiagnose one of the leading causes of mortality in the world? A new Australian study suggests that that could be the case.

Doctor
New research suggests a large percentage of cancers are overdiagnosed by doctors each year.

It is well known that diagnosed cases of cancer have increased steadily in the developed world over the last few decades. An approximate 1 in 2 people are now diagnosed with cancer somewhere in their lifetime.

There are a number of reasons for this including an aging population, improving detection methods, and higher knowledge rates of cancer signs and symptoms.

Over time, too, the way health professionals treat cancer has changed. This is because of a better understanding of the cancer-causing genes and the development of better treatment methods.

Cancer treatment is also becoming more personalized as tools are becoming more readily accessible and, in some cases, more affordable to identify the genetic signatures of tumours.

Given these advancements in cancer research, diagnosis, and rehabilitation, a new Australian study explains the increasing problem of overdiagnosis. Overdiagnosis means health professionals treat cancers that do not actually cause harm with harsh cancer drugs, which can have a detrimental effect on the quality of life of the person.

The study’s findings now appear in the Australian Medical Journal. Prof. Paul Glasziou— the director of the Institute for Evidence-Based Healthcare at Bond University in Queensland, Australia— and the team found that doctors would overdiagnose about 11,000 women’s cancers and 18,000 men’s cancers each year.

The researchers say that overdiagnosis of cancer can have a negative impact on the mental health of a patient and force them to undergo aggressive treatments when they may not be needed.

They also argue that the risk of overdiagnosis overwhelmingly costs a great deal of money for healthcare systems.

The goal of the recent study was to estimate the proportion of Australian cancer diagnoses that can fairly be due to overdiagnosis by comparing the current and past lifetime cancer risks.

Doctors overdiagnose 24% of male cancers

The researchers gathered data from the Australian Institute of Health and Welfare to evaluate the recent (2012) and historical (1982) lifetime risks of five specific cancers being diagnosed. These Include:

  • prostate cancer
  • breast cancer
  • renal cancer
  • thyroid cancers
  • melanoma, which is a type of skin cancer

Researchers changed the data to allow the risk of dying from other causes, such as heart disease.

The actual lifetime risk of invasive cancers for women has rose by 8.6 per cent since 1982. Doctors have over-diagnosed 18 per cent of all women’s cancers. For men, the absolute lifetime risk of invasive cancers increased by 10.9 percent, and 24 percent of all men’s cancers were overdiagnosed by doctors.

The researchers also point out that, during routine procedures, most overdiagnoses occur that detect cancers that would otherwise remain undetected. They also say early detection of abnormal cells can also be attributed to overdiagnosis.

Despite higher overdiagnostic levels, more evidence is needed to demonstrate this before health policies can shift.

Some people would argue that overdiagnosis is better than underdiagnosis, and screening has been at the heart of saving the lives of many people.

There are many options available to treat the cancers that the researchers studied in this report, and many people can have long, healthy lives when using maintenance therapy to control these cancers.

It is important to note that a doctor has misdiagnosed the cancer, not overdiagnosed it, when a person receives a treatment worse than is appropriate for their type of cancer.

For this reason, it might not be appropriate to say that the growing problem of overdiagnosis would boost the screening of cancer progams.

Health professionals have developed these systems to save lives, and essentially, the sooner a cancer is diagnosed, the higher the chance of survival and the lower the risk of recurrence.

The proof for this is irrefutable, so it would be wise for researchers to examine the problem of overdiagnosis in greater depth before policymakers take any steps.

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