Solving the Problem of Overdiagnosis
Menée à partir des données des registres américains des cancers sur la période 1975-2012, cette étude évalue, chez les femmes âgées de 40 ans ou plus, l'effet de la généralisation du dépistage du cancer du sein par mammographie sur la taille de la tumeur au diagnostic et la mortalité spécifique, puis estime le taux de surdiagnostic associé
My patients’ fear of breast cancer is palpable. I see them fret over whether or not to have a mammogram, worry about false positive abnormalities, and struggle to pay for diagnostic evaluations for which they are not reimbursed. This collateral damage of screening is obvious to clinicians. However, increasing evidence now indicates a less obvious outcome of cancer screening — overdiagnosis of diseases that would never cause symptoms or death. The presence and effects of overdiagnosis are less tangible, buried in population statistics rather than patient encounters. Overdiagnosis of breast cancer has been suggested on the basis of multiple studies . . .
New England Journal of Medicine , éditorial, 2015