Overdiagnosis harms kids. Here ’s how to avoid it.

A fairly recent article in the Journal of Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students. It is sobering because it describes the potential harm that can come from it — harm I have personally witnessed. The issue is overdiagnosis, and it’s related to our relentless quest to explain everything. “Overdiagnosis” is the term the authors use to describe a situation in which a true abnormality is discovered, but detection of that abnormality does not benefit the patient. It is not the same as misdiagnosis, meaning the diagnosis is inaccurate. It is also distinct from overtreatment or overuse, in which excessive treatment is given to patients for both correct and incorrect diagnoses. Overdiagnosis means finding something which, although abnormal, doesn’t help the patient in any way. Some of the most controversial and compelling examples of overdiagnosis come from cancer research. Two of the most common cancers — prostate cancer for men and breast cancer for women — run smack into the issue. It is certainly generally true early diagnosis and treatment of cancer is better than late diagnosis and treatment —usually, not always. A problem can arise when we use screening tests for early cancer as a mandate to treat them aggressively when we find them. The PSA (prostate-specific antigen) blood test was developed when researchers noticed it went up in men with prostate canc...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Pediatrics Source Type: blogs