Cancer Overdiagnosis Problems Result in Unnecessary Treatments, Risks: Report

A series of recent editorials published in a prominent medical journal suggests that several types of “low-risk” cancers should not be labeled as “cancer”, due to the risks associated with over-treatment. 

In an editorial published in The BMJ on August 16, researchers explained that some cancers should be labeled as “abnormalities” and treated differently from other cancers, since unnecessary treatments may pose a greater risk. The researchers warn that some harmless cancers are often overdiagnosed, which occurs when a condition is diagnosed that, if it went unrecognized, would not cause symptoms or cause harm to the patient.

Researchers emphasized that the cancer overdiagnosis problems are largely a result of the widespread push for early screenings. While such screenings are an extremely important part of catching serious illness early, it can lead to unnecessary treatments for more benign conditions.

Cancer overdiagnosis not only leads to over treatment, it can also lead to diagnosis related anxiety or depression, and increased financial burden, the researchers warn.

Many factors contribute to overdiagnosis, including the use of advanced diagnostic technology, medical culture that encourages increased screening and treatments, use of non-beneficial screening tests, and broadening disease definitions, according to the researchers.

In another editorial published in The BMJ on August 17, a separate group of researchers warned that overdiagnosis is difficult to identify and difficult to explain to patients. Researchers warn it “turns people into patients unnecessarily” and leads to wasted resources, unnecessary side effects, and unnecessary treatment. They suggested that some diagnoses may need to be labeled in other ways, and doctors should stop using the term cancer in some cases.

Other researchers published another editorial published in The BMJ on August 16, which emphasized the need for doctors to stop using the term cancer to describe certain low-risk lesions. They warn it “might be doing more harm than good.”

Instead, what are now considered low-risk cancers should be labeled as microtumors, abnormal cells, or indolent lesions of low malignant potential, they argued. These labels may perhaps be less scary for patients. More so, it may prompt both doctors and patients to take the “wait and see” approach, or active surveillance, instead of aggressively treating low-risk cancers.

In many cases, patients receiving active surveillance do just as well as those who have surgery. Often, active surveillance offers positive long term outcomes.

“Using loaded labels such as ‘cancer’ can make patients more worried, which can cause them to choose more aggressive management options—with more risk of harm,” the authors wrote.

For decades, cancer has been associated with grim outcomes, including death, and screenings have been touted as saving lives. In many cases, that is true and screenings do save lives. However, for patients with low-risk cancers, screenings may cause more harm than good. the researchers stressed.

They indicated that changing the terminology could help shift patient and doctor perceptions. It could help doctors recommend less invasive options and prompt patients to choose less invasive treatments.