J Korean Med Assoc.  2017 Apr;60(4):323-329. 10.5124/jkma.2017.60.4.323.

Overdiagnosis in health care: impact of cancer screening

• Ahn HS

• KMID: 2378216
• DOI: http://doi.org/10.5124/jkma.2017.60.4.323

Abstract

While overtreatment in medical services has for a long time been a topic of interest among the medical community, the concept of overdiagnosis has recently attracted interest because of the increasing scientific evidence supporting it; there are numerous academic papers investigating "˜overdiagnosis' which have been published. Overdiagnosis is the phenomenon of a disease being diagnosed that will never progress to the point of causing symptoms or death. In certain individuals, even despite the detection of cancer cells, the person will die of other disease before the cancer can progress. It is known that overdiagnosis occurs in various diseases, such as high blood pressure, diabetes, and various psychiatric disorders. In cancer, there exist slow growing cancers in which symptoms and death often occur late and thus the patient will ultimately die of another cause before they are affected by the cancer. Through this, there is a potential of overdiagnosis due to early cancer screening. Overdiagnosed patients are harmed by the diagnosis and treatment which in no way benefit them. The general public as well as health care professionals should be informed of the balance between the benefits and harms. This article will analyze the problems related to overdiagnosis with a focus on early screening in cancer.

Keyword

Medical overuse; Overdiagnosis, cancer screening; Thyroid neoplasms; Prostate neoplasms; Breast neoplasms

MeSH Terms

Breast Neoplasms
Delivery of Health Care*
Diagnosis
Early Detection of Cancer*
Humans
Hypertension
Mass Screening
Medical Overuse*
Prostatic Neoplasms
Thyroid Neoplasms

Figure

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  Figure 1 The heterogeneity of cancer biology.

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  Figure 2 Pattern of increased cancer incidence, with unchanged death rate suggesting overdiagnosis.

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  Figure 3 Cancer incidence and mortality in Korea (1999-2013). (A) Thyroid cancer, (B) prostate cancer, and (C) breast cancer.

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