Defining, Estimating, and Communicating Overdiagnosis in Cancer Screening
Authors: Louise Davies, Diana B. Petitti, Meghan Woo, Jennifer S. Lin
Journal: Annals of Internal Medicine (2018)

Letters4 December 2018Defining, Estimating, and Communicating Overdiagnosis in Cancer ScreeningLouise Davies, MD, MS, Diana B. Petitti, MD, MPH, Meghan Woo, ScD, ScM, and Jennifer S. Lin, MD, MCRLouise Davies, MD, MSGeisel School of Medicine at Dartmouth and Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (L.D.)Search for more papers by this author, Diana B. Petitti, MD, MPHUniversity of Arizona College of Medicine—Phoenix, Phoenix, Arizona (D.B.P.)Search for more papers by this author, Meghan Woo, ScD, ScMAbt Associates, Cambridge, Massachusetts (M.W.)Search for more papers by this author, and Jennifer S. Lin, MD, MCRKaiser Permanente Research Affiliates Evidence-based Practice Center and Kaiser Permanente Center for Health Research, Portland, Oregon (J.S.L.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0517 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We are glad that our proposed definition of overdiagnosis in the setting of cancer screening, which we recommend be applied when estimates that will be used in policy and public communication are being calculated, has raised discussion. As Dr. Carter and colleagues noted in their 2015 article on the challenges of creating a definition, “Broader and narrower conceptions of overdiagnosis are suited to different purposes” (1). We did not intend for our definition to extend outside the setting of cancer screening. We also are aware that our definition does not entirely account for the counterfactual, which cannot be ...References1. Carter SM, Rogers W, Heath I, Degeling C, Doust J, Barratt A. The challenge of overdiagnosis begins with its definition. BMJ. 2015;350:h869. [PMID: 25740625] doi:10.1136/bmj.h869 CrossrefMedlineGoogle Scholar2. Hofmann B. Getting personal on overdiagnosis: on defining overdiagnosis from the perspective of the individual person. J Eval Clin Pract. 2018;24:983-7. [PMID: 30066394] doi:10.1111/jep.13005 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Geisel School of Medicine at Dartmouth and Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire (L.D.)University of Arizona College of Medicine—Phoenix, Phoenix, Arizona (D.B.P.)Abt Associates, Cambridge, Massachusetts (M.W.)Kaiser Permanente Research Affiliates Evidence-based Practice Center and Kaiser Permanente Center for Health Research, Portland, Oregon (J.S.L.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0694. 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 Stacy M. Carter , Alexandra Barratt , Jenny Doust , and Chris Degeling Metrics Cited byStratification of cystic renal masses into benign and potentially malignant: applying machine learning to the bosniak classification 4 December 2018Volume 169, Issue 11Page: 824KeywordsCancer screeningDisclosurePublic policy ePublished: 4 December 2018 Issue Published: 4 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...