Tag: overtreatment

926px-40F_MLO_DMMG

How accurately do physicians estimate risk and benefit?

A new study suggests that physicians tend to overestimate the benefits of treatments, tests, and screening tests, while also underestimating harms.

/ January 26, 2017
Reading mammograms

Mammography and overdiagnosis, revisited

Another new study supports the hypothesis that overdiagnosis is a major problem in mammography screening programs. Predictably, it is attacked based on a misunderstanding of what overdiagnosis is.

/ October 17, 2016
Female doctor showing medical chart to female patient lying in hospital bed

When science- and evidence-based guidelines conflict with patient wishes: What’s a doc to do?

We use the term "science-based medicine" (SBM) because medicine isn't a science. The best medicine, however, is based in science. Patient values are also important, but what is a science-based doctor to do when SBM conflicts with what a patient or family wants?

/ October 3, 2016

Confusing overdiagnosis for an “epidemic” of thyroid cancer in Japan after Fukushima

One of my favorite topics to blog about for SBM is the topic of overdiagnosis and overtreatment. These are two interrelated phenomena that most people are blissfully unaware of. Unfortunately, I’d also say that the majority of physicians are only marginally more aware than the public about these confounders of screening programs, if even that. Overdiagnosis has long been appreciated to be...

/ March 14, 2016
WalkChewGum

On “integrative medicine” and walking and chewing gum at the same time

Evidence matters. Science matters. However, when advocates of "integrating" quackery into medicine via the vehicle of "integrative medicine" invoke weak science and poor quality evidence in conventional medicine in response to criticism, what they are really doing is deflecting attention away from their quackery. More importantly, advocates of science-based medicine are capable of walking and chewing gum at the same time. We...

/ November 16, 2015
Mammography

The American Cancer Society’s new mammography guidelines: Déjà vu all over again

One of the things that feels the weirdest about having done the same job, having been in the same specialty, for a longer and longer time is that you frequently feel, as the late, great Yogi Berra would have put it, déjà vu all over again. This is particularly true in science and medicine, where the same issues come up again and...

/ October 21, 2015
Venipuncture_using_a_BD_Vacutainer

“Liquid biopsies” for cancer screening: Life-saving tests, or overdiagnosis and overtreatment taken to a new level?

I’ve written many times about how the relationship between the early detection of cancer and decreased mortality from cancer is not nearly as straightforward as the average person—even the average doctor—thinks, the first time being in the very first year of this blog’s existence. Since then, the complexities and overpromising of various screening modalities designed to detect disease at an early, asymptomatic...

/ September 28, 2015
An example of ductal carcinoma in situ.

How should we treat DCIS?

I’ve written more times than I can remember about the phenomenon of overdiagnosis and the phenomenon that is linked at the hip with it, overtreatment. Overdiagnosis is a problem that arises when large populations of asymptomatic, apparently healthy people are screened for a disease or a condition, the idea being that catching the disease at an earlier stage in its progression will...

/ August 23, 2015

The uncertainty surrounding mammography continues

Mammography is a topic that, as a breast surgeon, I can’t get away from. It’s a tool that those of us who treat breast cancer patients have used for over 30 years to detect breast cancer earlier in asymptomatic women and thus decrease their risk of dying of breast cancer through early intervention. We have always known, however, that mammography is an...

/ July 13, 2015

Recent Developments and Recurring Dilemmas in Cancer Screening: Colon, Lung, Thyroid

A new stool DNA test was recently approved by the FDA for colon cancer screening. My first reaction was “Yay! I hope it’s good enough to replace all those unpleasant, expensive screening colonoscopies.” But of course, things are never that simple. I wanted to explain the new test for our readers; but before I could start writing, some other issues in cancer...

/ November 18, 2014