Overdiagnosis in the context of access to new medical technologies
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Zakład Etyki i Filozofii Człowieka, Wydział Pielęgniarstwa i Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie
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Anna Zagaja   

Zakład Etyki i Filozofii Człowieka, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie, ul. S. Staszica 4/6, 20-059 Lublin
Med Og Nauk Zdr. 2016;22(1):1-6
Dynamic development of new diagnostics technologies in medicine leads to their wide application in medical practice and screening tests, especially in screening for cancer. These tests in their assumptions are to detect diseases at an early stage of development, enabling early treatment and contributing to mortality reduction. However, reports indicating an increasing phenomenon of overdiagnosis and unnecessary treatment have begun to appear.

Aim of the study:
The aim of this study is to introduce the phenomenon of overdiagnosis, the distinction of this problem from similar phenomena, indication of the main areas of its occurrence and consequences

Current state of knowledge:
Overdiagnosis can be an unnecessary psychological, physical and financial burden to the patients and an unjustified financial expenditure for the country. Overdiagnosis is most frequently associated with screening for cancer (e.g. prostate, breast, lung); however, it also exists in clinical medicine and on the OTC market. Single reports indicate that in some medical diagnosis (e.g. prostate cancer), overdiagnosis can occur in even 40–60% of cases, and sometimes may lead to further unnecessary treatment.

In introducing new medical technologies and planning screening, it is essential to take into consideration the risk of overdiagnosis, and take action in order to reduce the phenomenon.

Oficjalna strona cyklu konferencji http://www.preventingoverdiagn.... net/documents/Brochure.pdf (dostęp:2014.10.29).
Welch GH, Schwartz L, Woloshin S. Overdiagnosed: Making People Sick in the Pursuit of Health Hardcover. Beacon Press, Boston, 2012.
Broeders M, Paci E. The balance sheet of benefits and harms of breast cancer population-based screening in Europe: outcome research, practice and future challenges. Womens Health. 2015; 11 (6): 883–890.
Etzioni R, Gulati R. Recognizing the Limitations of Cancer Overdiagnosis Studies: A First Step Towards Overcoming Them. J Natl Cancer Inst. 2015; 108(3): djv345.
Woolston C. Breast cancer: 4 big questions. Nature. 2015; 527(7578): 120.
Sohn E. Screening: Don›t look now. Nature. 2015; 527(7578): 118–9.
Dobruch J, Chłosta PL, Borówka A. Badania przesiewowe mające na celu wczesne wykrycie raka stercza w XXI wieku. Post Nauk Med. 2012; 4: 347–350.
Braczkowski M, Białożyt M, Braczkowski R, Kondera-Anasz Z. PSA ciągle najlepszy marker nowotworowy, modyfikacje testu i nowe markery raka stercza. Ann Acad Med Siles. 2011; 65 (1–2): 89–98.
Schwartz LM, Woloshin S, Sox HC, Fischhoff B, Welch HG. US women’s attitudes to false positive mammography results and detection of duc¬tal carcinoma in situ: cross sectional survey. BMJ. 2000; 320(7250): 1635–40.
Waller J, Douglas E, Whitaker KL, Wardle J. Women›s responses to information about overdiagnosis in the UK breast cancer screening programme: a qualitative study. BMJ Open 2013; 3: e002703.
Podstawowe informacje o rozwoju demograficznym Polski do 2013 do_2013.pdf (dostęp: 2014.10.28).
Rocznik Demograficzny 2013 – Główny Urząd Statystyczny http://stat. (dostęp: 2014.10.28).
Narodowy Program Zdrowia na lata 2007–2015 pl/__data/assets/pdf_file/0020/12494/zal_urm_npz_90_15052007p. pdf (dostęp:2014.29.10).
Sprawozdanie Ministra Zdrowia z realizacji narodowego programu zwalczania chorób nowotworowych w 2013 roku pl/__data/assets/pdf_file/0004/18850/Sprawozdanie-NPZCHN-2013r. pdf (dostęp 2014.10).
Esserman LJ, Thompson IM Jr, Reid B. Overdiagnosis and overtreatment in cancer: an opportunity for improvement. JAMA. 2013; 310(8): 797–8.
Esserman L, Shieh Y, Thompson I. Rethinking screening for breast cancer and prostate cancer. JAMA. 2009; 302(15): 1685–1692.
Dror N. The Incentive for “Imaging based cancer patients’ management” http://pharmaceuticalintellige.... (dostęp: 2014.10.27).
Etzioni R, Penson DF, Legler JM, di Tommaso D, Boer R, Gann PH, Feuer EJ. Overdiagnosis due to prostate-specific antigen screening: lessons from U.S. prostate cancer incidence trends. J Natl Cancer Inst. 2002; 94(13): 981–90.
Black WC. Overdiagnosis: An underrecognized cause of confusion and harm in cancer screening. J NatlCancer Inst. 2000; 92(16):1280–2.
K. Jorgonsen, P. Gotzsche. Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends. BMJ 2009; 339: b2587.
Orme NM, Fletcher JG, Siddiki HA, Harmsen WS, O›Byrne MM, Port JD, Tremaine WJ, Pitot HC, McFarland EG, Robinson ME, Koenig BA, King BF, Wolf SM. Incidental findings in imaging research: evaluating incidence, benefit, and burden. Arch Intern Med. 2010; 170(17): 1525–32.
Moynihan R1, Doust J, Henry D. Preventing overdiagnosis: how to stop harming the healthy. BMJ. 2012; 28; 344: e3502.
SciuttoMJ., Eisenberg M. Evaluating the evidence for and against the overdiagnosis of ADHD. J AttenDisord. 2007; 11(2):106–13.
Herndon MB, Schwartz LM, Woloshin S, Welch G. Implications of expanding disease definitions: the case of osteoporosis. Health Aff. 2007; 26: 1702–1711.
Welch G. 2012. Cancer Survivor or Victim of Overdiagnosis? http:// (dostęp: 2014.11.12).
Esserman LJ, Thompson IM Jr, Reid B. Overdiagnosis and overtreatment in cancer: an opportunity for improvement. JAMA. 2013; 310(8): 797–9.
Gershon-Cohen J, Forman M. Mammography of cancer. Bull N Y Acad Med. 1964; 40(9): 674–689.
Zackrisson S, Andersson I, Janzon L, Manjer J, Garne JP. Rate of over-diagnosis of breast cancer 15 years after end of Malmö mammographic screening trial: follow-up study. BMJ. 2006; 332(7543): 689–92.
Welch HG, Schwartz LM, Woloshin S. Ramifications of screening for breast cancer: 1 in 4 cancers detected by mammography are pseudo-cancers. BMJ. 2006; 332(7543): 727.
Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med. 2012; 367(21): 1998–2005.
Gøtzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2011; 1: CD001877.
Hersch J, Jansen J, Barratt A, Irwig L, Houssami N, Howard K, Dhillon H, McCaffery K. Women’s views on overdiagnosis in breast cancer screening: a qualitative study. BMJ. 2013; 346: f158.
Hersch J, Jansen J, Barratt A, Irwig L, Houssami N, Howard K, Dhillon H, McCaffery K. Women’s views on overdiagnosis in breast cancer screening: a qualitative study. BMJ. 2013; 345: f158.
Telesca D, Etzioni R, Gulati R. Estimating lead time and overdiagnosis associated with PSA screening from prostate cancer incidence trends. Biometrics 2008; 64(1):10–9.
Draisma G, Boer R, Otto SJ, van der Cruijsen IW, Damhuis RA, Schröder FH, de Koning HJ. Lead times and overdetection due to prostate-specific antigen screening: estimates from the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst. 2003; 95(12):868–78.
Loeb S, Bjurlin MA, Nicholson J, Tammela TL, Penson DF, Carter HB, Carroll P, Etzioni R. Overdiagnosis and overtreatment of prostate cancer. Eur Urol. 2014; 65(6): 1046–55.
Ilic D, Neuberger MM, Djulbegovic M, Dahm P. Screening for prostate cancer. Cochrane Database Syst Rev. 2013; 1: CD004720.
Coldiron BM, Mellette JR Jr, Hruza GJ, Helm TN, Garcia CA. Addressing overdiagnosis and overtreatment in cancer. Lancet Oncol. 2014; 15(8): e307.
Kolata G. ‘Cancer’ or ‘Weird Cells’: Which Sounds Deadlier? http:// (dostęp: 2014.11.09).
Strona “Chosing wisely” inicjatywy amerykańskiej fundacji ABIM (dostęp:2014.11.09).
Pawlikowski J. Kodeks Etyki Lekarskiej. Odc. 13: O swobodzie działań zawodowych. Med Prakt. 2014; 3(277): 116–119.
Moynihan R, Heath I, Henry D. Selling sickness: the pharmaceutical industry and disease mongering. BMJ 2002; 324(7342): 886–91.
Dear JW, Webb DJ. Disease mongering -- a challenge for everyone involved in healthcare. Br J ClinPharmacol. 2007; 64(2): 122–4.
Moynihan R. Scientists find new disease: motivational deficiency disorder BMJ. 2006; 332(7544): 745.
Woloshin S, Schwartz LM. Giving legs to restless legs: a case study of how the media helps make people sick. PLoS Med. 2006; 3(4): e 170.
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