For the past 30 years, awareness and screening have led to an emphasis on the early diagnosis of cancer. The goals were to get screened and to catch cancer early to reduce the rate of late-stage disease and to decrease cancer mortality. However, improved screening has resulted in the overdiagnosis and overtreatment of cancers that are not life-threatening, without significantly decreasing the death rate from the disease. In March 2012, the National Cancer Institute (NCI) convened a meeting to review the evidence on overdiagnosis.
In a recently published article, a working group has issued a call for major changes in the way the medical profession classifies and thinks about cancer, and in the way screening programs are designed (Esserman LJ, et al. JAMA. 2013;310:797-798).
The working group outlined 5 major recommendations for the NCI to consider.
The panel noted that these recommendations are only initial approaches. Policies that prevent or reduce the chances of overdiagnosis and overtreatment are needed. Physicians and patients are urged to have open discussions about these complex issues. The media also must begin to better comprehend and communicate these messages to the public about the potential hazard of overdiagnosis and overtreatment of cancer to ensure that the approach to screening for cancer can be improved.