Coming next year — yes, the wheels of science grind slow, but
they grind fine — the Preventing Overdiagnosis Conference.
Overdiagnosis means that people who have some condition that
will never harm them get a disease label and, almost inevitably,
treatment. Said treatment is at the very least costly, quite
likely harmful, and the person must live with an unsettling and
possibly even stigmatizing consciousness of being sick, or “at
risk.” Overdiagnosis comes from screening that can’t
discriminate well between dangerous and harmless lesions.
Examples are mammography for breast cancer, and PSA for prostate
cancer. Those have been much belabored here. It also happens
when the threshold for declaring that a “disease” exists is set
too low, so that on average the costs of treatment outweigh the
benefits. We may have done this with high blood pressure,
diabetes, and kidney disease. And it happens when we define
diseases that may not even exist, or for which the cure right
now is worse than the disease. I’m tempted t