Opinion: Overdiagnosing and making well people sick
Is there such a thing as being too cautious about one's health? That question is explored today by ECU's Professor Moira Sims who considers the effectiveness of the tests and subsequent treatments and whether the process will end up being more of a benefit than an unnecessary hindrance.
In healthcare it is widely accepted that early diagnosis and treatment makes good sense as taking timely action usually means better outcomes.
However, as technology advances we are developing more and more tests which can detect problems earlier and earlier.
What we must remember is that as our ability to pick up "problems" in the body increases we may be detecting diseases, such as early and slow-growing cancers, that were never going to cause a problem in the patient's lifetime.
In these cases it is possible that living with the diagnosis, getting the side effects of treatment or having treatment that isn't very effective might be a worse outcome than if the disease went undetected.
We must keep all of this in mind when we talk about screening people who have no symptoms for diseases.
Before we start to meddle with an otherwise healthy population we first need to know that the test is effective and that the treatment options are going to be effective.
We must consider how many lives we are likely to save by the screening, balanced against the number of people who will be harmed by the testing or treatment.
And finally we must determine if, as a society, we can afford the cost of the screening.
An example of population screening that is not necessarily leading to better patient outcomes is the South Korean program of screening for thyroid cancer.
In 2011 they diagnosed around 40,000 cases more than 100 times greater than the number of people who died from thyroid cancer that year.
It is estimated that one third of adults worldwide have small papillary thyroid cancer, the majority of which will not produce symptoms in the person's lifetime.
Despite this, in South Korea the majority of those diagnosed undergo treatment which can have significant side effects.
Ultimately the best defence against overdiagnosis is a good, open relationship between patients and their doctor.
We should welcome the increasing health literacy and interest in the community in sharing health decisions.
We can provide information on the pros and cons of testing so that people can make informed choices.
This article first appeared on ScienceNetwork Western Australia a science news website based at Scitech.
