If overdiagnosed with cancer, was something done wrong? Maybe. Maybe not.
“Overdiagnosis” means the detection of disease that, if untreated, would never cause symptoms or death. The disease may be detected through screening tests designed to detect life-threatening cancer at an early, curable stage or through tests performed for evaluation of some other condition.
The problem—and, hence, the “over”—is that once people and their doctors know they have the disease, they may be inclined to treat it.
Why would people treat a non-threatening cancer with therapies that may cause harm? Because they can’t be certain whether the disease will, in fact, remain silent and never pose a threat. That’s something they can know only in retrospect.
Calling it overdiagnosis implies something was overdone (i.e., done wrong). Everything could have been done properly, and we are dealing with a consequence of sensitive tests essential for saving lives and limbs..
If anything was wrong, it was not the diagnosis—accurate information about what is. If there was a problem, it was with…
Over-testing: ordering tests not indicated, which increases the chance of finding incidental abnormalities.
Over-treatment: Prescribing treatment without considering the option of active surveillance (following the disease without treating) if a disease that might prove indolent.
Standards and recommendations about tests and treatments will always keep changing as we learn more about disease found incidentally or through screening, and as we develop new treatments.
Given the uncertainty of medicine, it is a judgement call whether to order tests and which to order. If disease is found, it is a judgment call whether to follow or treat. Healthy Survivors make informed decisions about tests and treatments. This helps avoid over-testing and over-treatment.
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