Defining, Estimating, and Communicating Overdiagnosis in Cancer Screening
Authors: Stacy M. Carter, Alexandra Barratt, Jenny Doust, Chris Degeling
Journal: Annals of Internal Medicine (2018)

Letters4 December 2018Defining, Estimating, and Communicating Overdiagnosis in Cancer ScreeningStacy M. Carter, PhD, MPH(Hons), Alexandra Barratt, PhD, MBBS, MPH, Jenny Doust, PhD, BMBS, Grad Dip Clin Epi, and Chris Degeling, PhD, BVSc, Grad Dip SciStacy M. Carter, PhD, MPH(Hons)University of Wollongong, Wollongong, New South Wales, Australia (S.M.C., C.D.)Search for more papers by this author, Alexandra Barratt, PhD, MBBS, MPHUniversity of Sydney, Sydney, New South Wales, Australia (A.B.)Search for more papers by this author, Jenny Doust, PhD, BMBS, Grad Dip Clin EpiBond University, Gold Coast, Queensland, Australia (J.D.)Search for more papers by this author, and Chris Degeling, PhD, BVSc, Grad Dip SciUniversity of Wollongong, Wollongong, New South Wales, Australia (S.M.C., C.D.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0515 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Davies and colleagues' article (1) referenced old work of ours that did not define overdiagnosis. They also omitted work by others (2–4) that did define it. We have stated elsewhere (5) that overdiagnosis of a condition occurs in a population when the condition is being identified and labeled with a diagnosis in that population (consequent interventions may also be offered), this identification and labeling would be considered correct by a relevant professional community, but the resulting label and/or intervention carries an unfavorable balance between benefits and harms. Of note, this definition applies beyond cancer screening, because other ...References1. Davies L, Petitti DB, Martin L, Woo M, Lin JS. Defining, estimating, and communicating overdiagnosis in cancer screening. Ann Intern Med. 2018;169:36-43. [PMID: 29946705]. doi:10.7326/M18-0694 LinkGoogle Scholar2. Welch HG, Black WC. Overdiagnosis in cancer. J Natl Cancer Inst. 2010;102:605-13. [PMID: 20413742] doi:10.1093/jnci/djq099 CrossrefMedlineGoogle Scholar3. Rogers WA, Mintzker Y. Getting clearer on overdiagnosis. J Eval Clin Pract. 2016;22:580-7. [PMID: 27149914] doi:10.1111/jep.12556 CrossrefMedlineGoogle Scholar4. Carter JL, Coletti RJ, Harris RP. Quantifying and monitoring overdiagnosis in cancer screening: a systematic review of methods. BMJ. 2015;350:g7773. [PMID: 25569206] doi:10.1136/bmj.g7773 CrossrefMedlineGoogle Scholar5. Carter SM, Degeling C, Doust J, Barratt A. A definition and ethical evaluation of overdiagnosis. J Med Ethics. 2016;42:705-14. [PMID: 27402883] doi:10.1136/medethics-2015-102928 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Wollongong, Wollongong, New South Wales, Australia (S.M.C., C.D.)University of Sydney, Sydney, New South Wales, Australia (A.B.)Bond University, Gold Coast, Queensland, Australia (J.D.)Grant Support: All authors are supported by National Health and Medical Research Council grant 1104136, which focuses on understanding and addressing overdiagnosis and overtreatment in health care.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L18-0515. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDefining, Estimating, and Communicating Overdiagnosis in Cancer Screening Louise Davies , Diana B. Petitti , Lynn Martin , Meghan Woo , and Jennifer S. Lin Defining, Estimating, and Communicating Overdiagnosis in Cancer Screening Louise Davies , Diana B. Petitti , Meghan Woo , and Jennifer S. Lin Metrics 4 December 2018Volume 169, Issue 11Page: 823-824KeywordsCancer detection and diagnosisCancer screeningCommunication in health careDisclosureHealth careHealth services researchResearch grants ePublished: 4 December 2018 Issue Published: 4 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...