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Lung Cancer Screening Using Low-Dose Computed Tomography
Published in Ayman El-Baz, Jasjit S. Suri, Lung Imaging and CADx, 2019
Alison Wenholz, Ikenna Okereke
A positive diagnosis of cancer that would not have progressed to cause symptoms or increase patient mortality is known as overdiagnosis. Overdiagnosis may occur because the cancer is biologically indolent and would have never grown large enough or cause symptoms before other factors in a patient's life caused mortality. Overdiagnosis also occurs in situations in which a patient is found to have a lung nodule that ultimately is not cancer. This mode of overdiagnosis is much more common. In these cases, patients may undergo unnecessary surveillance imaging, invasive diagnostic interventions, or unneeded surgical resection. The probability that lung cancer detected by LDCT in the NLST study was an overdiagnosis was 18.5% [9]. Patients who are diagnosed with lung cancer by LDCT may ultimately undergo invasive diagnostic procedures and surgical resection when their tumors may be clinically insignificant [9]. The New York Times published an article about the risk of overdiagnosis of lung cancer using LDCT. The article concluded that the invasive follow-up to a positive screening test is no longer trivial in patients over the age of 65 and that patients should have autonomy in the decision-making process to start screening [10]. The benefits of increased diagnosis of stage I lung cancer resulting in a decreased mortality rate outweigh the risk of overdiagnosis.
Analyzing overdiagnosis risk in cancer screening: A case of screening mammography for breast cancer
Published in IISE Transactions on Healthcare Systems Engineering, 2018
Mahboubeh Madadi, Mohammadhossein Heydari, Shengfan Zhang, Edward Pohl, Chase Rainwater, Donna L. Williams
Preventive health services with advanced technologies, although known to detect diseases in early stages when patients are more likely to be successfully treated, have ignited a debate on overdiagnosis. Ideally, screening interventions aim to detect diseases that will ultimately cause harm, and the purpose of screening interventions is to advance the detection time, when the disease is in its early stages and is more likely to be treated. However, there is always the risk of overdiagnosis and overtreatment when detecting a disease in its early stages. Overdiagnosis of a disease is defined as the diagnosis of an asymptomatic disease having no signs or symptoms, which would have never become symptomatic during an individual's remaining lifetime.