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Healthy Skepticism Library item: 20592

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Wegwarth O, Gigerenzer G
Overdiagnosis and Overtreatment: Evaluation of What Physicians Tell Their Patients About Screening Harms
JAMA Internal Med 2013 Dec; 173:(22):2086-2087
http://archinte.jamanetwork.com/article.aspx?articleID=1754987


Abstract:

Cancer screening can produce benefits: finding true and treatable cancer at an early stage. However, it also can produce harms by overdiagnosis and overtreatment.1- 3 Overdiagnosis is the detection of pseudodisease—screening-detected abnormalities that meet the pathologic definition of cancer but will never progress to cause symptoms. The consequence of overdiagnosis is overtreatment—surgery, chemotherapy, or radiation—that provides the patient no benefits, but only adverse effects. For instance, for every 2000 women attending mammography screening throughout 10 years, 1 less dies of breast cancer. Concurrently, approximately 10 women with pseudodisease receive a diagnosis of breast cancer and are unnecessarily treated.4 Are patients informed about overdiagnosis by their physicians when discussing cancer screening? How much overdiagnosis would they tolerate when deciding to start or continue screening?

 

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...to influence multinational corporations effectively, the efforts of governments will have to be complemented by others, notably the many voluntary organisations that have shown they can effectively represent society’s public-health interests…
A small group known as Healthy Skepticism; formerly the Medical Lobby for Appropriate Marketing) has consistently and insistently drawn the attention of producers to promotional malpractice, calling for (and often securing) correction. These organisations [Healthy Skepticism, Médecins Sans Frontières and Health Action International] are small, but they are capable; they bear malice towards no one, and they are inscrutably honest. If industry is indeed persuaded to face up to its social responsibilities in the coming years it may well be because of these associations and others like them.
- Dukes MN. Accountability of the pharmaceutical industry. Lancet. 2002 Nov 23; 360(9346)1682-4.