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"Over diagnosis" OR overdiagnosis

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https://www.readbyqxmd.com/read/28216328/outcomes-of-prostate-cancer-screening-by-5-alpha-reductase-inhibitor-usage
#1
Teemu J Murtola, Anniina Virkku, Kirsi Talala, Ulf-Håkan Stenman, Kimmo Taari, Teuvo Lj Tammela, Anssi Auvinen
PURPOSE: Prostate cancer (PCa) screening with prostate-specific antigen (PSA) reduces PCa mortality, but leads to overdiagnosis of indolent PCa. Use of 5-alpha reductase inhibitors (5-ARIs) lowers PSA and in theory could affect performance of PSA-based screening. We evaluated outcomes of PCa screening among 5-ARI users. MATERIALS AND METHODS: The study was performed within the Finnish Randomized Study of Screening for Prostate Cancer. Of 80,454 men, 31,866 were randomized to be screened at four-year intervals during 1996-2004...
February 16, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28215847/prostate-cancer-screening-in-men-aged-50-to-69-years-sthlm3-a-prospective-population-based-diagnostic-study-gr%C3%A3-nberg-h-adolfsson-j-aly-m-nordstr%C3%A3-m-t-wiklund-p-brandberg-y-thompson-j-wiklund-f-lindberg-j-clements-m-egevad-l-eklund-m-lancet-oncol-2015-dec-16
#2
Eggener Scott, J Adolfsson, M Aly, T Nordström, P Wiklund, Y Brandberg, J Thompson, F Wiklund, J Lindberg, M Clements, L Egevad, M Eklund
BACKGROUND: The prostate-specific antigen (PSA) test is used to screen for prostate cancer but has a high false-positive rate that translates into unnecessary prostate biopsies and overdiagnosis of low-risk prostate cancers. We aimed to develop and validate a model to identify high-risk prostate cancer (with a Gleason score of at least 7) with better test characteristics than that provided by PSA screening alone. METHODS: The Stockholm 3 (STHLM3) study is a prospective, population-based, paired, screen-positive, diagnostic study of men without prostate cancer aged 50 to 69 years randomly invited by date of birth from the Swedish Population Register kept by the Swedish Tax Agency...
March 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28214381/the-value-of-reflectance-confocal-microscopy-in-diagnosis-of-flat-pigmented-facial-lesions-a-prospective-study
#3
E Wurm, G Pellacani, C Longo, H P Soyer, S Gonzalez, R Hofmann-Wellenhof, V Ahlgrimm-Siess, P Guitera, C Sinz, H Kittler
BACKGROUND: Flat pigmented facial lesions are difficult to diagnose even with dermatoscopy. It is controversial how additional information obtained by in vivo reflectance confocal microscopy (RCM) impacts the diagnosis and management. OBJECTIVE: To examine what in vivo reflectance confocal microscopy of flat pigmented facial lesions adds to clinical examination using dermatoscopy including digital dermatoscopic monitoring. METHODS: We prospectively collected 70 cases of flat pigmented facial lesions and recorded diagnoses and management decisions by experts based on direct clinical examination aided by dermatoscopy including digital dermatoscopic monitoring and by remote experts who reviewed the corresponding confocal images...
February 18, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28210564/more-misinformation-on-breast-cancer-screening
#4
COMMENT
Daniel B Kopans
Unfortunately, a great deal of misinformation has accumulated in the breast cancer screening literature that is based on flawed analyses in an effort to reduce access to screening. Quite remarkably, much of this has come from publications in previously highly respected medical journals. In several papers the intervention (mammography screening) is faulted yet the analyses provided no data on who participated in mammography screening, and which cancers were detected by mammography screening. It is remarkable that a highly respected journal can fault an intervention with no data on the intervention...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28209437/the-accuracy-of-preoperative-rigid-stroboscopy-in-the-evaluation-of-voice-disorders-in-children
#5
Jobran Mansour, Ofer Amir, Doron Sagiv, Eran E Alon, Michael Wolf, Adi Primov-Fever
OBJECTIVES: Stroboscopy is considered the most appropriate tool for evaluating the function of the vocal folds but may harbor significant limitations in children. Still, direct laryngoscopy (DL), under general anesthesia, is regarded the "gold standard" for establishing a diagnosis of vocal fold pathology. The aim of the study is to examine the accuracy of preoperative rigid stroboscopy in children with voice disorders. STUDY DESIGN: This is a retrospective study...
February 13, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28201927/histologic-findings-and-cytological-alterations-in-thyroid-nodules-after-radioactive-iodine-treatment-for-graves-disease
#6
Siba El Hussein, Yumna Omarzai
Unlike the well-documented relation between radiation to the neck and development of papillary thyroid carcinoma, a causal association between radioactive iodine treatment for Graves' disease and development of thyroid malignancy is less defined. However, patients with a background of thyroid dysfunction presenting with clinically palpable thyroid nodules are followed more closely than the average population, and fine needle aspiration is recommended in such circumstances. Cytological examination of aspirates, and histologic examination of tissue provided from patients with a known history of Graves' disease, managed by radioactive iodine therapy can create a diagnostic dilemma, as the distinction between radiation effect and a malignant primary thyroid neoplasm can be very challenging...
February 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28201871/a-targeted-contrast-agent-specific-to-an-oncoprotein-in-tumor-microenvironment-with-the-potential-for-detection-and-risk-stratification-of-prostate-cancer-with-mri
#7
Zheng Han, Yajuan Li, Sarah Roelle, Zhuxian Zhou, Yuchi Liu, Rob Sabatelle, Aidan DeSanto, Xin Yu, Hui Zhu, Cristina Magi-Galluzzi, Zheng-Rong Lu
Accurate detection and risk stratification are paramount to the clinical management of prostate cancer. Current diagnostic methods, including prostate specific antigen (PSA) screening, are unable to differentiate high-risk tumors from low-risk tumors, resulting in overdiagnosis and overtreatment of numerous patients. A peptide targeted contrast agent, ZD2-Gd(HP-DO3A), specific to an oncoprotein in tumor microenvironment, EDB-FN, was synthesized for non-invasive detection and characterization of aggressive prostate cancer...
February 16, 2017: Bioconjugate Chemistry
https://www.readbyqxmd.com/read/28194522/a-prospective-multi-institutional-validity-study-to-evaluate-the-accuracy-of-clinical-diagnosis-of-pathological-stage-iii-gastric-cancer-jcog1302a
#8
Takeo Fukagawa, Hitoshi Katai, Junki Mizusawa, Kenichi Nakamura, Takeshi Sano, Masanori Terashima, Seiji Ito, Takaki Yoshikawa, Norimasa Fukushima, Yasuyuki Kawachi, Takahiro Kinoshita, Yutaka Kimura, Hiroshi Yabusaki, Yasunori Nishida, Yoshiaki Iwasaki, Sang-Woong Lee, Takashi Yasuda, Mitsuru Sasako
BACKGROUND: Neoadjuvant chemotherapy (NAC) followed by radical surgery is a promising strategy to improve survival of patients with stage III gastric cancer, but is associated with the risk of preoperative overdiagnosis by which patients with early disease may receive unnecessary intensive chemotherapy. METHODS: We assessed the validity of a preoperative diagnostic criterion in a prospective multicenter study. Patients with gastric cancer with a clinical diagnosis of T2/T3/T4, M0, except for diffuse large tumors and extensive bulky nodal disease, were eligible...
February 13, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28191370/overestimating-overdiagnosis-in-breast-cancer-screening
#9
EDITORIAL
Alan Hollingsworth
Overdiagnosis in breast cancer has been a focus of increasing concern with wide ranges of calculations made indirectly through the study of prospective randomized trials and analyses of large registries. While most admit that some degree of overdiagnosis is inherent with ductal carcinoma in situ (DCIS), the rate of overdiagnosis with invasive disease is highly controversial. Although it is generally accepted that overdiagnosis is calculated through indirect means and deductive reasoning, this is not entirely the case...
January 9, 2017: Curēus
https://www.readbyqxmd.com/read/28191285/autoantibodies-against-oncogenic-erg-protein-in-prostate-cancer-potential-use-in-diagnosis-and-prognosis-in-a-panel-with-c-myc-amacr-and-herv-k-gag
#10
Anshu Rastogi, Amina Ali, Shyh-Han Tan, Sreedatta Banerjee, Yongmei Chen, Jennifer Cullen, Charles P Xavier, Ahmed A Mohamed, Lakshmi Ravindranath, Jigisha Srivastav, Denise Young, Isabell A Sesterhenn, Jacob Kagan, Sudhir Srivastava, David G McLeod, Inger L Rosner, Gyorgy Petrovics, Albert Dobi, Shiv Srivastava, Alagarsamy Srinivasan
Overdiagnosis and overtreatment of prostate cancer (CaP) is attributable to widespread reliance on PSA screening in the US. This has prompted us and others to search for improved biomarkers for CaP, to facilitate early detection and disease stratification. In this regard, autoantibodies (AAbs) against tumor antigens could serve as potential candidates for diagnosis and prognosis of CaP. Towards this, our goals were: i) To investigate whether AAbs against ERG oncoprotein (overexpressed in 25-50% of Caucasian American and African American CaP) are present in the sera of CaP patients; ii) To evaluate an AAb panel to enhance CaP detection...
November 2016: Genes & Cancer
https://www.readbyqxmd.com/read/28185408/full-field-digital-mammography-is-the-apparent-increased-detection-of-microcalcification-leading-to-over-investigation-and-over-diagnosis
#11
Alan J Porter, Elizabeth B Evans, Lisa M Erzetich
INTRODUCTION: Modern full-field digital mammography (FFDM) appears to have increased the detection of breast microcalcification. This retrospective study aimed to assess whether this is associated with over-investigation and possible over-diagnosis of breast pathology of lesser significance. METHODS: Three 2-year periods were studied, in which different mammographic technologies were used exclusively viz., classical screen-film mammography (SFM) in 2003-04, computed radiography (CR) in 2009-10 and FFDM in 2012-13...
February 9, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28173779/thyroid-fine-needle-aspiration-biopsy-positively-correlates-with-increased-diagnosis-of-thyroid-cancer-in-south-korean-patients
#12
Yoon Jae Cho, Do Young Kim, Eun-Cheol Park, Kyu-Tae Han
BACKGROUND: The incidence of thyroid cancer among South Koreans is more than 10-fold greater than its incidence in other countries, although its associated mortality rate is similar. Amidst concerns regarding the over-diagnosis of thyroid cancer related to gradually expanded medical testing in South Korea, we hypothesized that the number of thyroid fine-needle aspiration biopsies has led to increased diagnosis of thyroid cancer. METHODS: We used data from the National Health Insurance Service National Sample Cohort 2003-2013, which included all medical claims filed for the 1,122,456 people in a nationally representative sample...
February 7, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28170394/performance-and-cost-effectiveness-of-computed-tomography-lung-cancer-screening-scenarios-in-a-population-based-setting-a-microsimulation-modeling-analysis-in-ontario-canada
#13
Kevin Ten Haaf, Martin C Tammemägi, Susan J Bondy, Carlijn M van der Aalst, Sumei Gu, S Elizabeth McGregor, Garth Nicholas, Harry J de Koning, Lawrence F Paszat
BACKGROUND: The National Lung Screening Trial (NLST) results indicate that computed tomography (CT) lung cancer screening for current and former smokers with three annual screens can be cost-effective in a trial setting. However, the cost-effectiveness in a population-based setting with >3 screening rounds is uncertain. Therefore, the objective of this study was to estimate the cost-effectiveness of lung cancer screening in a population-based setting in Ontario, Canada, and evaluate the effects of screening eligibility criteria...
February 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28170392/refining-lung-cancer-screening-criteria-in-the-era-of-value-based-medicine
#14
Steven D Shapiro
In a Perspective on the Research Article by ten Haaf and colleagues, Steven Shapiro discusses the challenges of identifying screening strategies that maximize the number of cancers diagnosed, while minimizing the harms of overdiagnosis and maintaining cost-effectiveness.
February 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28170085/guarding-against-overtesting-overdiagnosis-and-overtreatment-of-older-adults-thinking-beyond-imaging-and-injuries-to-weigh-harms-and-benefits
#15
EDITORIAL
Jerome R Hoffman, Christopher R Carpenter
No abstract text is available yet for this article.
February 7, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28162815/improving-the-rotterdam-european-randomized-study-of-screening-for-prostate-cancer-risk-calculator-for-initial-prostate-biopsy-by-incorporating-the-2014-international-society-of-urological-pathology-gleason-grading-and-cribriform-growth
#16
Monique J Roobol, Jan F M Verbeek, Theo van der Kwast, Intan P Kümmerlin, Charlotte F Kweldam, Geert J L H van Leenders
BACKGROUND: The survival rate for men with International Society of Urological Pathology (ISUP) grade 2 prostate cancer (PCa) without invasive cribriform (CR) and intraductal carcinoma (IDC) is similar to that for ISUP grade 1. If updated into the European Randomized Study of Screening for Prostate Cancer (ERSPC Rotterdam) risk calculator number 3 (RC3), this may further improve upfront selection of men who need a biopsy. OBJECTIVE: To improve the number of possible biopsies avoided, while limiting undiagnosed clinically important PCa by applying the updated RC3 for risk-based patient selection...
February 2, 2017: European Urology
https://www.readbyqxmd.com/read/28158214/communicating-about-overdiagnosis-learning-from-community-focus-groups-on-osteoporosis
#17
Ray Moynihan, Rebecca Sims, Jolyn Hersch, Rae Thomas, Paul Glasziou, Kirsten McCaffery
BACKGROUND: Overdiagnosis is considered a risk associated with the diagnosis of osteoporosis-as many people diagnosed won't experience harm from the condition. As yet there's little evidence on community understanding of overdiagnosis outside cancer- where it is an established risk of some screening programs-or effective ways to communicate about it. We examined community understanding around overdiagnosis of osteoporosis, to optimise communication strategies about this problem. METHODS AND FINDINGS: Using a qualitative design we recruited a community sample of women, 50-80 years, from the Gold Coast community around Bond University, Australia, using random digit dialing, and conducted 5 focus groups with 41 women...
2017: PloS One
https://www.readbyqxmd.com/read/28154351/natural-history-of-thyroid-cancer-review
#18
Toru Takano
Thyroid cancers have long been considered to arise in middle age and, after their repeated proliferation, resulting in further damage to the genome, they progress to more aggressive and lethal cancers. However, in 2014, some studies were reported that might lead to a marked change in our understanding of the natural history of thyroid cancer. A high prevalence of papillary carcinoma in the young suggested that the first initiation of thyroid cancer is likely to occur in the infantile period. Such a conclusion was also supported by a very slow growth rate of papillary microcarcinomas (PMCs) in an observation trial...
February 2, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28150105/skin-cancer-epidemiology-disease-burden-pathophysiology-diagnosis-and-therapeutic-approaches
#19
REVIEW
Zoe Apalla, Dorothée Nashan, Richard B Weller, Xavier Castellsagué
Skin cancer, including both melanoma and non-melanoma, is the most common type of malignancy in the Caucasian population. Firstly, we review the evidence for the observed increase in the incidence of skin cancer over recent decades, and investigate whether this is a true increase or an artefact of greater screening and over-diagnosis. Prevention strategies are also discussed. Secondly, we discuss the complexities and challenges encountered when diagnosing and developing treatment strategies for skin cancer...
January 2017: Dermatology and Therapy
https://www.readbyqxmd.com/read/28145105/a-qualitative-study-on-a-decision-aid-for-breast-cancer-screening-views-from-women-and-health-professionals
#20
A Toledo-Chávarri, M Rué, N Codern-Bové, M Carles-Lavila, L Perestelo-Pérez, M J Pérez-Lacasta, M Feijoo-Cid
This qualitative study evaluates a decision aid that includes the benefits and harms of breast cancer screening and analyses women's perception of the information received and healthcare professionals' perceptions of the convenience of providing it. Seven focus groups of women aged 40-69 years (n = 39) and two groups of healthcare professionals (n = 23) were conducted in Catalonia and the Canary Islands. The focus groups consisted of guided discussions regarding decision-making about breast cancer screening, and acceptability and feasibility of the decision aid...
February 1, 2017: European Journal of Cancer Care
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