The latest buzz word in the medical blogosphere is ‘overdiagnosis‘. This iatrogenic neologism is increasingly being seen as a significant threat to human health.
Overdiagnosis is the diagnosis of “disease” that will never cause symptoms or death during a patient’s lifetime.
Evidence is mounting that medicine is potentially harming healthy people through ever earlier detection and ever wider definition of disease. In Ray Moynihan’s latest article published in the British Medical Journal, he and co-authors (Jenny Doust, and David Henry) lay out the nature of the problem, describe some examples, explore causes and flag some possible solutions.
Overdiagnosis happens when people get a diagnosis they don’t need. It can happen when people without symptoms are diagnosed and then treated for a disease that won’t actually cause them any symptoms, and it can happen for people whose symptoms or life experiences are given a diagnostic label which will bring them more harm than good.
Fierce debates are raging in many specialist areas, from psychiatry to kidney medicine, over whether the boundaries defining illness have been pushed too wide and whether too many people are being turned into patients unnecessarily. To this end an international conference – Preventing Overdiagnosis will take place on September 10-12, 2013, at Dartmouth College in the United States.
Certainly, in Australia we are quickly heading down the hypochondriacal path to investigation cornucopia – a land filled with plethoric neologisms and myriad acronyms designed to make us all sleep well at night, assured in the knowledge that our behaviour has been labelled, categorised and thank goodness is treatable by a little blue/white/pink/green pill.
Thanks to a new government initiative we will now be able to medicalise normal behaviour from the age of three, so thankfully our children will be able to leave kindergarten without the ability to kick a ball, but with a diagnosis they are unable to read or write. Soon the only things left inadequately labelled with be our food products and those too young to talk…
- Preventing overdiagnosis: how to stop harming the healthy BMJ 2012;344:e3502
- Overdiagnosis – BMJ Blog
- Preventing Overdiagnosis Conference
- Avoiding Avoidable care conference
- Advances in radiology and the real versus apparent effects of early diagnosis European Journal of Radiology Volume 27, Issue 2 , Pages 116-122, May 1998 [Abstract]
- Overdiagnosis in Cancer: JNCI J Natl Cancer Inst (2010) 102(9): 605-613.doi: 10.1093/jnci/djq099 [FullText]
- Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends BMJ 2009;339:b2587 [FullText]