Breast Cancer Overdiagnosis
Cancer screening is a common method to detect cancer early. Patients, usually in their 40s to 70s, will either go once a year or every other year for a checkup, where an ultrasound or other technique will scan for cancer. Over the past decades, early cancer detection from screening has reduced cancer deaths significantly because patients are given treatment options that are effective and more affordable. Currently, the U.S. Preventive Services Task Force (USPSTF) has recommended regular screening for cervical, colorectal, breast, and lung cancer to be beneficial for certain groups of people.
However, cancer screening also has negative side effects, as it is one of the possible causes of overdiagnosis. Overdiagnosis is when cancer screening detects a cancerous tumor that never would have caused issues in the patient’s lifetime. This is not uncommon, as cancer may grow extremely slowly and not pose a harm compared to other health factors, or the cancer may not progress at all. However, physicians often cannot distinguish these harmless cancers from dangerous ones, in which they will opt to give the patient treatment. This may result in completely unnecessary invasive and expensive treatment for the cancer, which can take a toll mentally and financially on patients. For example, cancer treatment in itself can cause the patient and their family immense stress over their health and mortality. Additionally, the cost of breast cancer treatment can be USD $60,000 or more, depending on the type of tumor and the stage of diagnosis, while also negatively affecting the patient’s ability to obtain health insurance.
However, cancer screening also has negative side effects, as it is one of the possible causes of overdiagnosis. Overdiagnosis is when cancer screening detects a cancerous tumor that never would have caused issues in the patient’s lifetime. This is not uncommon, as cancer may grow extremely slowly and not pose a harm compared to other health factors, or the cancer may not progress at all. However, physicians often cannot distinguish these harmless cancers from dangerous ones, in which they will opt to give the patient treatment. This may result in completely unnecessary invasive and expensive treatment for the cancer, which can take a toll mentally and financially on patients. For example, cancer treatment in itself can cause the patient and their family immense stress over their health and mortality. Additionally, the cost of breast cancer treatment can be USD $60,000 or more, depending on the type of tumor and the stage of diagnosis, while also negatively affecting the patient’s ability to obtain health insurance.
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To help address this concern with cancer screening, a research study funded by the National Cancer Institute (NCI) aimed to assess the exact rates of overdiagnosis in breast cancer. The study included 35,986 women who were 50-74 years old and racially, ethnically, and geographically diverse. Out of these women, researchers defined overdiagnosis as cases when the patient with screen-detected breast cancer died before they developed any symptoms of their cancer. 82,677 of their breast cancer screenings, also known as mammograms, were computer analyzed to help predict the rate of overdiagnosis, and the rates of harmless cancers and death from other factors were combined. After the analysis, the results predicted the overdiagnosis rate of breast cancer was 15.4%. This means that about one in seven of every breast cancer diagnosis is overdiagnosed. Additionally, the amount of overdiagnosis increases as patients age. However, in consideration of other studies the researchers could only conclude that the rate of breast cancer overdiagnosis lies between 0-54% due to the use of different measurements and definitions for overdiagnosis.
The existence of overdiagnosis can negatively impact those who experience it both financially and mentally. It is important to be wary of the benefits as well as the harms when explaining cancer prevention to patients, in order that they know the upsides to early diagnosis of cancer, but also know the possibility of overdiagnosis and the increased likelihood of overdiagnosis as they age. Physicians and researchers are also looking for ways in which to decrease the rate of overdiagnosis such as reducing bias and familial pressure towards screening, and genomic technology that will better predict a patient’s risk for harmful cancer. However, further study investigating the exact rate of overdiagnosis for different cancers and types of patients is still needed to help quantify the problem.
The existence of overdiagnosis can negatively impact those who experience it both financially and mentally. It is important to be wary of the benefits as well as the harms when explaining cancer prevention to patients, in order that they know the upsides to early diagnosis of cancer, but also know the possibility of overdiagnosis and the increased likelihood of overdiagnosis as they age. Physicians and researchers are also looking for ways in which to decrease the rate of overdiagnosis such as reducing bias and familial pressure towards screening, and genomic technology that will better predict a patient’s risk for harmful cancer. However, further study investigating the exact rate of overdiagnosis for different cancers and types of patients is still needed to help quantify the problem.
Featured Image Source: Anna Shvets
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