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Daniel S Reuland, Laura Cubillos, Alison T Brenner, Russell P Harris, Bailey Minish, Michael P Pignone
BACKGROUND: The United States Preventive Services Task Force (USPSTF) issued recommendations for older, heavy lifetime smokers to complete annual low-dose computed tomography (LDCT) scans of the chest as screening for lung cancer. The USPSTF recommends and the Centers for Medicare and Medicaid Services require shared decision making using a decision aid for lung cancer screening with annual LDCT. Little is known about how decision aids affect screening knowledge, preferences, and behavior...
January 12, 2018: BMC Medical Informatics and Decision Making
Kimbroe J Carter, Frank Castro, Roy N Morcos
OBJECTIVE: The debate over the value of screening mammography is rekindled with each new published study or guideline. Central to the discussion are the uncertainties about screening benefits and harms and the criteria used to assess them. Today, the magnitude of benefits for a population is less certain, and the evolving concept of harm has come to encompass false-positives (FPs), unnecessary biopsies, overdiagnosis, and overtreatment. This study uses a Monte Carlo computer simulation to study the balance of benefits and harms of mammographic breast cancer screening for average-risk women...
January 11, 2018: AJR. American Journal of Roentgenology
Aaron M Udager, Scott A Tomlins
Prostate cancer, one of the most common noncutaneous malignancies in men, is a heterogeneous disease with variable clinical outcome. Although the majority of patients harbor indolent tumors that are essentially cured by local therapy, subsets of patients present with aggressive disease or recur/progress after primary treatment. With this in mind, modern clinical approaches to prostate cancer emphasize the need to reduce overdiagnosis and overtreatment via personalized medicine. Advances in our understanding of prostate cancer pathogenesis, coupled with recent technologic innovations, have facilitated the development and validation of numerous molecular biomarkers, representing a range of macromolecules assayed from a variety of patient sample types, to help guide the clinical management of prostate cancer, including early detection, diagnosis, prognostication, and targeted therapeutic selection...
January 8, 2018: Cold Spring Harbor Perspectives in Medicine
Harry Glauber, William M Vollmer, Gregory A Nichols
CONTEXT: Given the dramatic rise in the incidence of type 2 diabetes mellitus (T2DM) in recent decades, identifying individuals at increased risk of T2DM and validating methods to reduce their risk of disease progression is important. With more than one-third of US adults having prediabetes, a more precise stratification of absolute risk of T2DM incidence would help in prioritizing prevention efforts. OBJECTIVE: To develop a simple and clinically useful schema to stratify short-term (2-year) absolute risk of T2DM...
2018: Permanente Journal
Alessandro Fiocchi, Holger Schunemann, Ignacio Ansotegui, Amal Assa'ad, Sami Bahna, Roberto Berni Canani, Martin Bozzola, Lamia Dahdah, Christophe Dupont, Motohiro Ebisawa, Elena Galli, Haiqi Li, Rose Kamenwa, Gideon Lack, Alberto Martelli, Ruby Pawankar, Maria Said, Mario Sánchez-Borges, Hugh Sampson, Raanan Shamir, Jonathan Spergel, Luigi Terracciano, Yvan Vandenplas, Carina Venter, Susan Waserman, Gary Wong, Jan Brozek
Background: The 2010 Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines are the only Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines for cow's milk allergy (CMA). They indicate oral food challenge (OFC) as the reference test for diagnosis, and suggest the choice of specific alternative formula in different clinical conditions. Their recommendations are flexible, both in diagnosis and in treatment. Objectives & methods: Using the Scopus citation records, we evaluated the influence of the DRACMA guidelines on milk allergy literature...
2018: World Allergy Organization Journal
Jonathan Sicsic, Nathalie Pelletier-Fleury, Nora Moumjid
BACKGROUND: Over the past decade, the benefits and harms balance of breast cancer (BC) screening has been widely debated. OBJECTIVES: To elicit women's trade-offs between the benefits and harms of BC screening and to analyze the main determinants of these trade-offs. METHODS: A discrete-choice experiment with seven attributes depicting BC screening programs including varying levels of BC mortality, overdiagnosis, and false-positive result was used...
January 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Fabio M Ulivieri, Luca P Piodi, Enzo Grossi, Luca Rinaudo, Carmelo Messina, Anna P Tassi, Marcello Filopanti, Anna Tirelli, Francesco Sardanelli
The consolidated way of diagnosing and treating osteoporosis in order to prevent fragility fractures has recently been questioned by some papers, which complained of overdiagnosis and consequent overtreatment of this pathology with underestimating other causes of the fragility fractures, like falls. A new clinical approach is proposed for identifying the subgroup of patients prone to fragility fractures. This retrospective observational study was conducted from January to June 2015 at the Nuclear Medicine-Bone Metabolic Unit of the of the Fondazione IRCCS Ca' Granda, Milan, Italy...
2018: PloS One
Kiril Trpkov
Benign mimics present either as common challenges in daily routine practice or may cause diagnostic dilemmas because some are less commonly seen and one may be less familiar in recognizing them. There are a multitude of mimics of prostatic adenocarcinoma, which may represent normal gland structures, benign proliferations, atrophic lesions, hyperplastic or metaplastic changes, and inflammatory processes. Some of them are preferentially found in certain anatomic areas of the prostate, either confined to the prostate, or outside of the gland...
January 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Kevin Jenniskens, Joris A H de Groot, Johannes B Reitsma, Karel G M Moons, Lotty Hooft, Christiana A Naaktgeboren
OBJECTIVE: To provide insight into how and in what clinical fields overdiagnosis is studied and give directions for further applied and methodological research. DESIGN: Scoping review. DATA SOURCES: Medline up to August 2017. STUDY SELECTION: All English studies on humans, in which overdiagnosis was discussed as a dominant theme. DATA EXTRACTION: Studies were assessed on clinical field, study aim (ie, methodological or non-methodological), article type (eg, primary study, review), the type and role of diagnostic test(s) studied and the context in which these studies discussed overdiagnosis...
December 27, 2017: BMJ Open
Cédric Lemogne, Monica Turinici, Henri Panjo, Charlotte Ngo, Florence Canoui-Poitrine, Jean-Christophe Chauvet-Gelinier, Frédéric Limosin, Silla M Consoli, Marcel Goldberg, Marie Zins, Virginie Ringa
The potential benefit of breast cancer screening is mitigated by the risk of false positives and overdiagnosis, thus advocating for a more personalized approach, based on the individual benefit-harm balance. Since personality might influence the women's appraisal of this balance, this prospective observational cohort study examined whether it could influence mammography use. A total of 2691 postmenopausal women of the GAZEL Cohort Study completed the Bortner Type A Rating Scale and the Buss and Durkee Hostility Inventory in 1993...
December 26, 2017: Cancer Medicine
Adam L Hersh, Daniel J Shapiro, Andrew T Pavia, Katherine E Fleming-Dutra, Lauri A Hicks
INTRODUCTION: Antibiotic prescribing rates vary substantially across regions in the USA. Whether these differences are driven primarily by a greater tendency to treat certain infections (i.e., overtreatment) in certain regions or differences in the tendency to diagnose certain infections (i.e., overdiagnosis) is poorly understood. METHODS: We examined data from 2012 to 2013 using the National Ambulatory Medical Care Survey, which is a nationally representative sample of visits to office-based physicians...
December 22, 2017: Infectious Diseases and Therapy
Indu Elizabeth Mathew, Aju Mathew
Background: Thyroid cancer incidence is rising in high-income countries. This increase in disease burden is attributed to the phenomenon of overdiagnosis. Objective: We aimed to investigate trends in thyroid cancer rates in India, focusing on the state of Kerala in southern India, which has reported a high incidence of the disease. Design: Population-based study using data from the National Cancer Registry Program. Participants: We used data from the Population Based Cancer Registries for Thiruvananthapuram (capital of Kerala state), Delhi, Mumbai, Bangalore, and Chennai...
May 1, 2017: Journal of the Endocrine Society
Kai Zhang, Chris H Bangma, Monique J Roobol
Prostate cancer (PCa) is the second most common cancer among men worldwide and even ranks first in Europe. Although Asia is known as the region with the lowest PCa incidence, it has been rising rapidly over the last 20 years mostly due to the introduction of prostate-specific antigen (PSA) testing. Randomized PCa screening studies in Europe show a mortality reduction in favor of PSA-based screening but coincide with high proportions of unnecessary biopsies, overdiagnosis and subsequent overtreatment. Conclusive data on the value of PSA-based screening and hence the balance between harms and benefits in Asia is still lacking...
April 2017: Asian Journal of Urology
Tobias Nordström, Olof Akre, Markus Aly, Henrik Grönberg, Martin Eklund
BACKGROUND: Screening for prostate cancer using prostate-specific antigen (PSA) alone leads to un-necessary biopsying and overdiagnosis. PSA density is easily accessible, but early evidence on its use for biopsy decisions was conflicting and use of PSA density is not commonly recommended in guidelines. METHODS: We analyzed biopsy outcomes in 5291 men in the population-based STHLM3 study with PSA ≥ 3 ng/ml and ultrasound-guided prostate volume measurements by using percentages and regression models...
December 19, 2017: Prostate Cancer and Prostatic Diseases
Andrew M Kaunitz, JoAnn V Pinkerton, Sujata V Ghate, Andrew M D Wolf
This Practice Pearl describes an approach to screening mammography for average-risk women that encourages the use of shared decision-making that addresses benefits (early diagnosis and decreased mortality) and potential harms (false positives and overdiagnosis/overtreatment) in determining screening mammography initiation, frequency, and duration for women at average risk of breast cancer.
December 18, 2017: Menopause: the Journal of the North American Menopause Society
Ian A Rowe
Non-alcoholic fatty liver disease (NAFLD) is now the most common cause of liver disease. This remarkable rise in prevalence over the past 20 years is largely through the recognition of fatty liver in the absence of excessive alcohol consumption as a disease. The natural history of NAFLD is incompletely understood, and although a small proportion of individuals with NAFLD will develop complications of liver disease, most will not. This raises the prospect of widespread overdiagnosis of NAFLD. Clinical practice guidelines from the European specialist societies representing hepatology, endocrinology, and obesity endorse screening for NAFLD in at-risk groups, and this further increases the likelihood of overdiagnosis and consequent overtreatment through false-positive testing...
January 2018: Lancet. Gastroenterology & Hepatology
Hans Concin, Gabriele Nagel
Prevention and management of breast cancer in order to provide high quality health care is an important public health issue. The existence of overdiagnosis for breast-cancer was controversial for a long time but is now broadly accepted. Overdiagnosis is defined as the diagnosis of "disease" that will never cause symptoms or death during a patient's ordinarily expected lifetime. Estimates of the overdiagnosis rate for breast cancer range up to 54% of screen-detected localized tumors. New approaches, such as the identification of high risk groups or primary prevention approaches could be more relevant from the public health perspective...
December 16, 2017: Hormone Molecular Biology and Clinical Investigation
Marios K Georgakis, Nick Dessypris, Margarita Baka, Maria Moschovi, Vassilios Papadakis, Sophia Polychronopoulou, Maria Kourti, Emmanuel Hatzipantelis, Eftichia Stiakaki, Helen Dana, Evdoxia Bouka, Luis Antunes, Joana Bastos, Daniela Coza, Anna Demetriou, Domenic Agius, Sultan Eser, Raluca Gheorghiu, Mario Sekerija, Maciej Trojanowski, Tina Zagar, Anna Zborovskaya, Anton Ryzhov, Athanassios Tragiannidis, Paraskevi Panagopoulou, Eva Steliarova-Foucher, Eleni Th Petridou
Neuroblastoma comprises the most common neoplasm during infancy (first year of life). This study describes incidence of neuroblastoma in Southern-Eastern Europe (SEE), including -for the first time- the Nationwide Registry for Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST)/Greece, compared to the US population, while controlling for Human Development Index (HDI). Age-adjusted incidence rates (AIR) were calculated for 1859 childhood (0-14 years) neuroblastoma cases, retrieved from 13 collaborating SEE registries (1990-2016), and were compared with those of SEER/US (N=3166; 1990-2012); temporal trends were assessed using Poisson regression and Joinpoint analyses...
December 18, 2017: International Journal of Cancer. Journal International du Cancer
Alessia Barisani, Salvatore D Infusino, Cosimo Misciali, Beatrice Passarini, Nunzio C Salfi, Elisa Varotti, Annalisa Patrizi
BACKGROUND: Atypical lentiginous melanocytic nevi (ALMNs) are atypical pigmented lesions with histopathological features similar to those of dysplastic nevi, with a lentiginous pattern. Variable histopathological features of ALMNs were observed in our practice. METHODS: We described the histopathological features of ALMNs diagnosed in the period 2009- 2015. Our cases were divided into 2 groups: Group 1: ALMNs showing the same histopathological features as previously described in the literature; Group 2: ALMNs with different features...
December 15, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Eiliv Lund, Aurelie Nakamura, Jean-Christophe Thalabard
BACKGROUND: The Norwegian Breast Cancer Screening Program (NBCSP) was implemented across the country in 2005 and has been criticised for potential 'overdiagnosis', i.e. a breast cancer diagnosis that otherwise would not have been detected or treated in a woman's lifetime. We aimed to estimate overdiagnosis in the NBCSP based on the Norwegian Women and Cancer (NOWAC) study using both questionnaire information and record linkage information from NBCSP. METHOD: For 124,978 women aged 49-79 years from the NOWAC study, information on screened women could be cross-validated from the NBCSP database...
December 12, 2017: European Journal of Cancer
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