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Highly Accessed Editorial

Pitfalls in accurate estimation of overdiagnosis: implications for screening policy and compliance

Stephen A Feig

Author Affiliations

Department of Radiological Sciences, UCI Medical Center, University of California Irvine School of Medicine, 101 City Drive South, Route 140, Orange, CA 92868- 3298, USA

Breast Cancer Research 2013, 15:105  doi:10.1186/bcr3448


See related research by Duffy and Parmar, http://breast-cancer-research.com/content/15/3/R41

Published: 8 August 2013

Abstract

Stories in the public media that 30 to 50% of screen-detected breast cancers are overdiagnosed dissuade women from being screened because overdiagnosed cancers would never result in death if undetected yet do result in unnecessary treatment. However, such concerns are unwarranted because the frequency of overdiagnosis, when properly calculated, is only 0 to 5%. In the previous issue of Breast Cancer Research, Duffy and Parmar report that accurate estimation of the rate of overdiagnosis recognizes the effect of lead time on detection rates and the consequent requirement for an adequate number of years of follow-up. These indispensable elements were absent from highly publicized studies that overestimated the frequency of overdiagnosis.