Patients Aware of Overdiagnosis Rates Would Avoid Screening

Patients who are informed of cancer overdiagnosis rates may avoid screening exams, according to an article published in JAMA Internal Medicine.

Cancer screenings are increasing awareness of disease and catching many cases early, however a drawback to increased screening is overdiagnosis, or pseudodisease, and the subsequent overtreatment of surgery, chemotherapy, or radiation.

“For every 2,000 women attending mammography screening throughout 10 years, one less dies of breast cancer. Concurrently, approximately 10 women with pseudodisease receive a diagnosis of breast cancer and are unnecessarily treated,” wrote the study authors.

The researchers, from the Max Planck Institute for Human Development, Harding Center for Risk Literacy, Berlin, Germany, undertook a survey of adults in the United States to determine how overdiagnosis may affect how patients view screening procedures. The subjects did not have any history of cancer.

A total of 317 adults (52.4 percent women, 47.6 percent men), aged 50 to 69 years completed an online survey that asked questions about if they had been informed of overdiagnosis risks and overtreatment and if they would continue with the screenings knowing the risks. Seventeen percent of the subjects had never undergone any cancer screening, 19.9 percent had one screening test, 36 percent had two, and 27.1 percent three or more screenings. The most common cancer screenings were mammography for women, as well as colonoscopy/sigmoidoscopy and PSA testing for men.

The results of the survey showed that only 30 subjects (9.5 percent) had discussed overdiagnosis with their physician. Fifty-one percent of the participants reported that they were unprepared to start a screening that results in more than one overtreated person per one life saved from cancer death, but 59 percent reported they would continue the cancer screening they receive regularly even if they learned that the test results in 10 overtreated people per one life saved from cancer death.

"The results of the present study indicate that physicians' counseling on screening does not meet patients' standards," the study concluded.