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"Over diagnosis" OR overdiagnosis

Ai Shimizu, Toshihiko Hoashi, Kasho Kataoka, Noriko Shirakawa, Nobuko Mayumi, Yoko Funasaka, Hidehisa Saeki
Verrucous carcinoma (VC) is an uncommon, distinct type of well-differentiated squamous cell carcinoma. Here we present two cases of VC, one arising from the lower leg and the other from genital skin. Case 1, a female patient, aged 95 years, had a brownish verrucous plaque on her right lower leg. Histopathologically, epithelial tumor cells grew pushing the stroma, while the basement membrane was intact. No prominent cellular atypia or hyperchromatin was found. Case 2, a male patient, aged 53 years, had a verrucous plaque at the border between his scrotum and inner aspect of his thigh...
2018: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Leonard Berlin
For the first 180 years following the founding of the US, physicians occasionally were sued for medical malpractice. Allegations of negligence were errors of commission - i.e. the physician made a mistake by doing something wrong, usually mistreatment of a fracture or dislocation, a complication or death following a surgical procedure, prescribing the wrong medication, and after the discovery of the X-ray by Roentgen in 1895, causing radiation burns. In the mid twentieth century malpractice allegations slowly changed from errors of commission to errors of omission - i...
September 26, 2017: Diagnosis
Maura Massimino, Douglas B Evans, Marta Podda, Claudio Spinelli, Paola Collini, Natalia Pizzi, Archie Bleyer
In adolescents and young adults, thyroid cancer accounts for 13% of all invasive neoplasms, being three times more frequent in females, but overdiagnosis and overtreatment are common. There are two therapeutic approaches, one radical and no longer preferred in all instances, and the other conservative. Permanent complications of surgery and metabolic irradiation can affect quality of life and carry an economic burden. The overall survival rate approaches 100% for patients with differentiated thyroid cancer regardless of the extent of treatment...
March 12, 2018: Pediatric Blood & Cancer
Daniel D Sjoberg, Andrew J Vickers, Melissa Assel, Anders Dahlin, Bing Ying Poon, David Ulmert, Hans Lilja
BACKGROUND: Prostate-specific antigen (PSA) screening reduces prostate cancer deaths but leads to harm from overdiagnosis and overtreatment. OBJECTIVE: To determine the long-term risk of prostate cancer mortality using kallikrein blood markers measured at baseline in a large population of healthy men to identify men with low risk for prostate cancer death. DESIGN, SETTING, PARTICIPANTS: Study based on the Malmö Diet and Cancer cohort enrolling 11 506 unscreened men aged 45-73 yr during 1991-1996, providing cryopreserved blood at enrollment and followed without PSA screening to December 31, 2014...
March 5, 2018: European Urology
Rajia Bahri, Adnan Custovic, Peter Korosec, Marina Tsoumani, Martin Barron, Jiakai Wu, Rebekah Sayers, Alf Weimann, Monica Ruiz-Garcia, Nandinee Patel, Abigail Robb, Mohamed H Shamji, Sara Fontanella, Mira Silar, E N Clare Mills, Angela Simpson, Paul J Turner, Silvia Bulfone-Paus
BACKGROUND: Food allergy is an increasing public health issue and the commonest cause of life-threatening anaphylactic reactions. Conventional allergy tests assess for the presence of allergen-specific IgE, significantly overestimating the rate of true clinical allergy resulting in over-diagnosis and adverse impact on health-related quality of life. OBJECTIVE: To undertake initial validation and assessment of a novel diagnostic tool, the mast cell activation test (MAT)...
March 5, 2018: Journal of Allergy and Clinical Immunology
Tomasz Nowikiewicz, Wojciech Zegarski, Iwona Głowacka-Mrotek
Overtreatment means treatment that goes beyond current standards, and patients with any disease can be overtreated. Overtreatment is also given to patients with cancer, including those who need surgery. Overtreatment is closely related to the problem of overdiagnosis. In patients with cancer, unnecessary surgery may cause complications and generates unnecessary costs. The size of the problem of unnecessary surgery in patients with cancer can best be shown among patients with the most common cancers, which dedicated screening programs...
February 28, 2018: Polski Przeglad Chirurgiczny
Yoshinobu Saitoh, Takao Setoguchi, Takako Yoshioka, Junichiro Nishi, Akihide Tanimoto, Setsuro Komiya
OBJECTIVE: The aim of this study was to evaluate whether intraoperative histopathological examination could predict the risk of relapse of infection in periprosthetic joint infections (PJI). METHODS: The study included 25 patients (14 women and 11 men, with a mean age of 67.0 years (range, 37-83 years)), who had two-staged revision surgery for a PJI. Following prosthetic removal in the first stage, all patient underwent an intraoperative histopathological examination during the second stage...
March 1, 2018: Acta Orthopaedica et Traumatologica Turcica
Luigino Dal Maso, Chiara Panato, Silvia Franceschi, Diego Serraino, Carlotta Buzzoni, Susanna Busco, Stefano Ferretti, Antonietta Torrisi, Fabio Falcini, Manuel Zorzi, Claudia Cirilli, Walter Mazzucco, Michele Magoni, Paolo Collarile, Fabio Pannozzo, Anna Luisa Caiazzo, Antonio Giampiero Russo, Alessio Gili, Adele Caldarella, Roberto Zanetti, Maria Michiara, Lucia Mangone, Rosa Angela Filiberti, Mario Fusco, Francesca Gasparini, Giovanna Tagliabue, Rosaria Cesaraccio, Rosario Tumino, Luciana Gatti, Francesco Tisano, Silvano Piffer, Giovanna Maria Sini, Guido Mazzoleni, Stefano Rosso, Anna Clara Fanetti, Salvatore Vaccarella
AIMS: In Italy, incidence rates of thyroid cancer (TC) are among the highest worldwide with substantial intracountry heterogeneity. The aim of the study was to examine time trends of TC incidence in Italy and to estimate the proportion of TC cases potentially attributable to overdiagnosis. METHODS: Data on TC cases reported to Italian cancer registries during 1998-2012 aged <85 years were included. Age-standardised incidence rates (ASR) were computed by sex, period, and histology...
March 1, 2018: European Journal of Cancer
Brooke Nickel, Juan P Brito, Ray Moynihan, Alexandra Barratt, Susan Jordan, Kirsten McCaffery
BACKGROUND: In recent years management practices in relation to low-risk papillary microcarcinoma (PMC) have been evolving with increased awareness of the potential overdiagnosis and overtreatment of PMCs, and guidelines recommendations for non-surgical management options such as active surveillance. This study aimed to develop an in-depth understanding of patients' experiences of the communication of their PMC diagnosis, their treatment preferences and decision making. METHODS: Semi-structured qualitative interviews with 25 patients diagnosed pre-operatively with PMC < 1 year since their diagnosis and treatment...
March 2, 2018: BMC Cancer
Benjamin L Mazer, H Gilbert Welch
No abstract text is available yet for this article.
March 2018: Archives of Pathology & Laboratory Medicine
Jean Liew, James Lundblad, Adam Obley
The overdiagnosis of thyroid malignancies may be contributing to the increased incidence of these cancers with a relatively stable mortality rate. We present the case of a man with known malignancies, who underwent biopsy of a suspicious thyroid nodule. This procedure was complicated by local anesthetic systemic toxicity (LAST). It is important to address goals of diagnostic testing and treatment with patients, particularly if further evaluation is unlikely to change management or outcomes.
December 16, 2017: Curēus
Weng Khong Lim, Sonia Davila, Jing Xian Teo, Chengxi Yang, Chee Jian Pua, Christopher Blöcker, Jing Quan Lim, Jianhong Ching, Jonathan Jiunn Liang Yap, Swee Yaw Tan, Anders Sahlén, Calvin Woon-Loong Chin, Bin Tean Teh, Steven G Rozen, Stuart Alexander Cook, Khung Keong Yeo, Patrick Tan
The use of consumer-grade wearables for purposes beyond fitness tracking has not been comprehensively explored. We generated and analyzed multidimensional data from 233 normal volunteers, integrating wearable data, lifestyle questionnaires, cardiac imaging, sphingolipid profiling, and multiple clinical-grade cardiovascular and metabolic disease markers. We show that subjects can be stratified into distinct clusters based on daily activity patterns and that these clusters are marked by distinct demographic and behavioral patterns...
February 2018: PLoS Biology
Mina Rydell, Sebastian Lundström, Christopher Gillberg, Paul Lichtenstein, Henrik Larsson
BACKGROUND: Studies have reported increases in clinically diagnosed and treated attention deficit hyperactivity disorder (ADHD) during the last decade, but it is unclear if this reflects an increase in the underlying ADHD phenotype. We aimed to clarify if there has been an increase in the prevalence of ADHD-like traits in the general population from 2004 to 2014. METHOD: Data were collected from 9-year-old twins (19,271), participating in the population-based Child and Adolescent Twin Study in Sweden between 2004 and 2014...
February 27, 2018: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Sara Loureiro-Vieira, Vera Marisa Costa, José Alberto Duarte, Margarida Duarte-Araújo, Salomé Gonçalves-Monteiro, Bastos Maria de Lourdes, Félix Carvalho, João Paulo Capela
Methylphenidate (MPH) is a first-line stimulant drug to treat attention deficit hyperactivity disorder (ADHD). Overdiagnosis of ADHD and MPH abuse lead to serious concerns about the possible long-term adverse consequences of MPH in healthy children and adolescents. We aimed to evaluate MPH effects in adolescent male Wistar rats (postnatal day 40) using an oral dose scheme (2 daily MPH doses 5 mg/kg in a 5% sucrose solution, 5 h apart, for 7 days) that mimics the therapeutic doses given to human adolescents...
February 23, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Pierre Martinez, Diego Mallo, Thomas G Paulson, Xiaohong Li, Carissa A Sanchez, Brian J Reid, Trevor A Graham, Mary K Kuhner, Carlo C Maley
The low risk of progression of Barrett's esophagus (BE) to esophageal adenocarcinoma can lead to over-diagnosis and over-treatment of BE patients. This may be addressed through a better understanding of the dynamics surrounding BE malignant progression. Although genetic diversity has been characterized as a marker of malignant development, it is still unclear how BE arises and develops. Here we uncover the evolutionary dynamics of BE at crypt and biopsy levels in eight individuals, including four patients that experienced malignant progression...
February 23, 2018: Nature Communications
Eric R Coon, Jacob Wilkes, Susan L Bratton, Rajendu Srivastava
OBJECTIVE: Compare trends in coronary artery (CA) abnormality diagnoses to trends in adverse cardiac outcomes among American children with Kawasaki disease (KD) to assess the fit of detection of CA abnormalities to an established model of overdiagnosis. DESIGN: Multicenter retrospective cohort. SETTING: 48 US children's hospitals in the Paediatric Health Information System database. PARTICIPANTS: Children <18 years receiving care for KD between 2000 and 2014...
February 22, 2018: Archives of Disease in Childhood
Kaitlin L Nufer, Anthony P Raphael, H Peter Soyer
No abstract text is available yet for this article.
February 21, 2018: JAMA Dermatology
Christa Haldrup, Anne Lykke Pedersen, Nadia Øgaard, Siri H Strand, Søren Høyer, Michael Borre, Torben Falck Ørntoft, Karina Dalsgaard Sørensen
Current diagnostic and prognostic tools for prostate cancer (PC) are suboptimal, leading to overdiagnosis and overtreatment. Aberrant promoter hypermethylation of specific genes has been suggested as novel candidate biomarkers for PC that may improve diagnosis and prognosis. We here analyzed ST6GALNAC3 and ZNF660 promoter methylation in prostate tissues, and ST6GALNAC3, ZNF660, CCDC181, and HAPLN3 promoter methylation in liquid biopsies. First, using four independent patient sample sets, including a total of 110 non-malignant (NM) and 705 PC tissue samples, analyzed by methylation specific qPCR or methylation array, we found that hypermethylation of ST6GALNAC3 and ZNF660 was highly cancer-specific with areas under the curve (AUC) of receiver operated characteristic (ROC) curve analysis of 0...
February 21, 2018: Molecular Oncology
Debashis Sahoo, Wei Wei, Heidi Auman, Antonio Hurtado-Coll, Peter R Carroll, Ladan Fazli, Martin E Gleave, Daniel W Lin, Peter S Nelson, Jeff Simko, Ian M Thompson, Robin J Leach, Dean A Troyer, Lawrence D True, Jesse K McKenney, Ziding Feng, James D Brooks
The introduction of serum Prostate Specific Antigen (PSA) testing nearly 30 years ago has been associated with a significant shift towards localized disease and decreased deaths due to prostate cancer. Recognition that PSA testing has caused over diagnosis and over treatment of prostate cancer has generated considerable controversy over its value, and has spurred efforts to identify prognostic biomarkers to distinguish patients who need treatment from those that can be observed. Recent studies show that cancer is heterogeneous and forms a hierarchy of tumor cell populations...
January 19, 2018: Oncotarget
Åsbjørn Schumacher Westvik, Harald Weedon-Fekjær, Jan Mæhlen, Knut Liestøl
BACKGROUND: Mammography screening is used to detect breast cancer at an early treatable stage, reducing breast cancer mortality. Traditionally, breast cancer has been seen as a disease with only progressive lesions, and here we examine the validity of this assumption by testing if incidence levels after introducing mammography screening can be reproduced assuming only progressive tumors. METHODS: Breast cancer incidence data 1990-2009 obtained from the initially screened Norwegian counties (Akershus, Oslo, Rogaland and Hordaland) was included, covering the time-period before, during and after the introduction of mammography screening...
February 20, 2018: BMC Cancer
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