Overdiagnosis and overtreatment: Evaluation of what physicians tell their patients about screening harms
A partir d'une enquête en ligne menée auprès de 317 participants américains d'âge compris entre 50 et 69 ans, cette étude analyse les informations délivrées par les médecins sur les risques associés à un test de détection précoce du cancer (surdiagnostic, surtraitement)
Cancer screening can produce benefits: finding true and treatable cancer at an early stage. However, it also can produce harms by overdiagnosis and overtreatment.Overdiagnosis is the detection of pseudodisease—screening-detected abnormalities that meet the pathologic definition of cancer but will never progress to cause symptoms. The consequence of overdiagnosis is overtreatment—surgery, chemotherapy, or radiation—that provides the patient no benefits, but only adverse effects. For instance, for every 2000 women attending mammography screening throughout 10 years, 1 less dies of breast cancer. Concurrently, approximately 10 women with pseudodisease receive a diagnosis of breast cancer and are unnecessarily treated. Are patients informed about overdiagnosis by their physicians when discussing cancer screening? How much overdiagnosis would they tolerate when deciding to start or continue screening?
JAMA Internal Medicine , résumé, 2012