Tag: overdiagnosis
Contrary to what we are frequently told, we are not “losing the war on cancer”
A common narrative about cancer is that we are making no progress in our fight against it. Fortunately, the actual data do not agree. Yes, too many people still die of cancer and progress is slow, but it's not correct to claim that we are losing the war on cancer.
The ADHD Controversy
ADHD was already a controversial diagnosis; are Jerome Kagan's recent criticisms of it warranted?
Mammography and overdiagnosis, revisited
Another new study supports the hypothesis that overdiagnosis is a major problem in mammography screening programs. Predictably, it is attacked based on a misunderstanding of what overdiagnosis is.
When science- and evidence-based guidelines conflict with patient wishes: What’s a doc to do?
We use the term "science-based medicine" (SBM) because medicine isn't a science. The best medicine, however, is based in science. Patient values are also important, but what is a science-based doctor to do when SBM conflicts with what a patient or family wants?
Uncertainty in Medicine
Medicine is an uncertain business. It is an applied science, applying the results of basic science knowledge and clinical studies to patients who are individuals with differing heredity, environment, and history. It is commonly assumed that modern science-based doctors know what they are doing, but quite often they don’t know for certain. Different doctors interpret the same evidence differently; there is uncertainty...
Reclassifying thyroid cancer and the willful misunderstanding of overdiagnosis
If there’s one lesson that we here at Science-Based Medicine like to emphasize, it’s that practicing medicine and surgery is complicated. Part of the reason that it’s complicated is that for many diseases our understanding is incomplete, meaning that physicians have to apply existing science to their treatment as well as they can. The biology of cancer, in particular, can be vexing....
Confusing overdiagnosis for an “epidemic” of thyroid cancer in Japan after Fukushima
One of my favorite topics to blog about for SBM is the topic of overdiagnosis and overtreatment. These are two interrelated phenomena that most people are blissfully unaware of. Unfortunately, I’d also say that the majority of physicians are only marginally more aware than the public about these confounders of screening programs, if even that. Overdiagnosis has long been appreciated to be...
On “integrative medicine” and walking and chewing gum at the same time
Evidence matters. Science matters. However, when advocates of "integrating" quackery into medicine via the vehicle of "integrative medicine" invoke weak science and poor quality evidence in conventional medicine in response to criticism, what they are really doing is deflecting attention away from their quackery. More importantly, advocates of science-based medicine are capable of walking and chewing gum at the same time. We...
The American Cancer Society’s new mammography guidelines: Déjà vu all over again
One of the things that feels the weirdest about having done the same job, having been in the same specialty, for a longer and longer time is that you frequently feel, as the late, great Yogi Berra would have put it, déjà vu all over again. This is particularly true in science and medicine, where the same issues come up again and...
“Liquid biopsies” for cancer screening: Life-saving tests, or overdiagnosis and overtreatment taken to a new level?
I’ve written many times about how the relationship between the early detection of cancer and decreased mortality from cancer is not nearly as straightforward as the average person—even the average doctor—thinks, the first time being in the very first year of this blog’s existence. Since then, the complexities and overpromising of various screening modalities designed to detect disease at an early, asymptomatic...