Overdiagnosis of Cancer—Not Only Associated With Aging
Cet article examine les raisons pouvant expliquer l'augmentation de l'incidence de certains cancers chez les adultes de moins de 50 ans aux Etats-Unis
Overdiagnosis is a phenomenon in which disease is detected (often by screening) that would not have led to significant symptoms or death. The earliest concept of overdiagnosis arose from autopsy studies that revealed the presence of asymptomatic, previously undiagnosed cancer at the time of death. Importantly, these early observations implicitly linked the phenomenon of overdiagnosis to age; for example, the estimated prevalence of incidental prostate cancer increases from approximately 5% in men younger than 30 years to over half of men in their 80s. The higher competing risk of mortality in older persons means it is less likely that any asymptomatic cancer would have the opportunity to become life limiting. This relationship, in which risk of overdiagnosis increases with age, has informed national screening guidelines not only for prostate cancer, but also for other screen-detectable cancers such as breast and colorectal cancer.
JAMA Internal Medicine , éditorial, 2025