Overdiagnosis ‘epidemic’ target of new alliance of medical professionals
SYDNEY: An alliance of doctors, patients, researchers and public organisations is developing a plan to deal with what it describes as an unacceptable level of overdiagnosis.
The senior research fellow at Bond University on the Gold Coast said the evidence of overdiagnosis was strongest in the cancer area.
“In 2016, for example, researchers estimated that more than half a million people, including 10,000 in Australia, may have been overdiagnosed with thyroid cancer over a 20-year period.
“There is strong evidence of overdiagnosis of prostate cancer and some evidence of overdiagnosis of breast cancers.
“There are estimates that perhaps 20 per cent of breast cancers and up to 20, 40 or 50 per cent of prostate cancers detected through screening may be overdiagnosed.”
A group convened by the National Cancer Institute in the United States has described overdiagnosis as a modern epidemic.
It said there were concerns across a wide range of conditions including pulmonary embolism, attention deficit hyperactivity disorder (ADHD), and pre-diabetes.
The article said there was increasing recognition of the need for some form of coordinated national response to develop evidence-informed strategies that could fairly and safely deal with the problem of overdiagnosis in Australia.
However, at the grassroots level, Royal Australian College of General Practitioners (RACGP) president Harry Nespolon said it was up to the doctor who saw the patient after a screening program to explain the best treatment option.
“It’s what you do with the answers from the screening program,” Dr Nespolon said.
“It’s about explaining the different sorts of treatments and what the consequences are.
“It should always be a joint decision between the patient and the doctor.”
The RACGP president said patients often did not believe they had had a successful consultation unless they were given a piece of paper, or they had been sent off for a test.
“Patients are becoming more sophisticated. They have extensive access to information, and doctors should be able to help them understand that information in the context of their particular problem.”
Dr Moynihan said in the desire of medical professionals to miss nothing, they were overdiagnosing too many healthy people.
“Doctors don’t want to miss early signs of cancer or disease, and patients don’t want anything to be missed, but overdiagnosis can lead to unnecessary treatments,” he said.
Dr Nespolon said GPs were aware of the importance of not overtreating patients.
“Both doctors and patients need to be educated about what medicine can and can’t do,” he said.
“Patients have very high expectations of the healthcare system.
“They need to understand that just because things are abnormal in a result does not mean something is very wrong with them.”
Dr Moynihan said researchers in Australia and around the world were still trying to work out the magnitude of the problem.
