Jack O’Sullivan (@JackOSullivan3) recounts highlights from the third Preventing Overdiagnosis Conference, hosted last week by U.S. National Cancer Institute.
Fifteen hundred years BC, the Ancient Egyptians recognised the potential harms of overtreatment – ‘tumor against the god Xenus, do thou nothing there against’. Millennia later, at the National Institutes of Health, the third Preventing Overdiagnosis Conference again provided much debate around medicine’s fundamental paradox: the harms of too much medicine.
Hosted by the National Cancer Institute (US), Oxford University’s Centre for Evidence-Based Medicine, Bond University, The Dartmouth Institute, Consumer Reports and the British Medical Journal (BMJ) clinicians, patients, academics and policy makers enjoyed a full three days of academic reflection.
Cancer, and the difficulty in delivering the appropriate diagnosis and treatment at the appropriate time, was extensively covered. Cancer screening is perhaps the most contentious example, with breast, cervical, prostate and thyroid discussed in detail. Fundamentally, where a significant increase in cancer incidence with no change in mortality is observed over time, there is a strong suspicion that the increased incidence represents cancer of no clinical significance. This argument is particularly compelling where the introduction of a new screening test coincides with a rapid increase in incidence. South Korea’s thyroid cancer ‘epidemic’(paywall), presented by Hyeong Sik Ahn of the Korea University School of Medicine, was perhaps the most striking example of this.