Ann Robinson’s research reviews—17 August 2023

Careful what you wish forDo we underestimate the harm done by overdiagnosis as a result of screening? We worry so much about missing pathology and far less about the consequences of overdiagnosis. This interesting retrospective cohort study of nearly 55 000 US women aged over 70 years compared the cumulative incidence of breast cancer in those who continued being screened with those who didn’t. Adjusted cumulative breast cancer incidence was greater among 70-74 years old who were screened compared with those who weren’t (6.1 v 4.2 cases/100 women), but an estimated 31% of breast cancer among screened women was potentially overdiagnosed. For women over 85 years, the cumulative incidence was 2.8 v 1.3/100 women with up to 54% considered to be overdiagnosis. Overall, there was no reduction in breast cancer-specific mortality associated with screening. A flaw of the study was that it couldn’t measure other benefits or harms of screening…
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