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Overdiagnosis and Overtreatment in Cancer
Journal of American Medical Association ^ | Jluy 29, 2013 | Laura J. Esserman, MD, MBA1; Ian M. Thompson, Jr, MD2; Brian Reid, MD, PhD3

Posted on 08/04/2013 8:07:43 AM PDT by Innovative

Optimal screening frequency depends on the cancer's growth rate. If a cancer is fast growing, screening is rarely effective. If a cancer is slow growing but progressive, with a long latency and a precancerous lesion (eg, colonic polyps or cervical intraepithelial neoplasia), screening is ideal and less frequent screening (eg, 10 years for colonoscopy) may be effective. In the case of an indolent tumor, detection is potentially harmful because it can result in overtreatment. These observations provide an opportunity to refocus screening on reducing disease morbidity and mortality and lower the burden of cancer screening and treatments.

In March 2012, the National Cancer Institute convened a meeting to evaluate the problem of "overdiagnosis," which occurs when tumors are detected that, if left unattended, would not become clinically apparent or cause death. Overdiagnosis, if not recognized, generally leads to overtreatment

(Excerpt) Read more at jama.jamanetwork.com ...


TOPICS: Health/Medicine; Science
KEYWORDS: cancer; cancerscreening; deathpanels; medicalcare; nochemo4you; obamacare; obamacaredeathpanels; overdiagnosis
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Another article based on the JAMA original one:

NCI Panel: Stop Calling Low-Risk Lesions 'Cancer'. New Proposals to Reduce Overdiagnosis.

The practice of oncology in the United States is in need of a host of reforms and initiatives to mitigate the problem of overdiagnosis and overtreatment of cancer, according to a working group sanctioned by the National Cancer Institute.

Perhaps most dramatically, the group says that a number of premalignant conditions, including ductal carcinoma in situ and high-grade prostatic intraepithelial neoplasia, should no longer be called "cancer."

====

There is one "little" problem with all this -- when you have early detection, you can't tell whether it will progress fast or slowly and by the time you are sure, you can go buy your casket, because it's too late.

But expect to see more and more of these articles, as Obamacare expands -- doctors and people need to be "educated" so they won't seek treatment, which cost money, of course, but go and die quietly.

1 posted on 08/04/2013 8:07:43 AM PDT by Innovative
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To: neverdem

Ping - I noticed you are interested and post medical articles.


2 posted on 08/04/2013 8:08:18 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: Innovative

They’re trying to explain the skyrocketing numbers of cancer diagnosis.

Sure, cancer ‘deaths’ are going down. But at a huge expense from treatment costs. The problem is the ongoing increase in diagnosis of cancer.


3 posted on 08/04/2013 8:09:56 AM PDT by Black Agnes
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To: Innovative

More from the JAMA article:

“Physicians, patients, and the general public must recognize that overdiagnosis is common and occurs more frequently with cancer screening. Overdiagnosis, or identification of indolent cancer, is common in breast, lung, prostate, and thyroid cancer. Whenever screening is used, the fraction of tumors in this category increases. By acknowledging this consequence of screening, approaches that mitigate the problem can be tested.

Change cancer terminology based on companion diagnostics. Use of the term “cancer” should be reserved for describing lesions with a reasonable likelihood of lethal progression if left untreated. “


4 posted on 08/04/2013 8:11:19 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: Black Agnes

” The problem is the ongoing increase in diagnosis of cancer.”

Yes, that’s the “real problem”. (/sarcasm)


5 posted on 08/04/2013 8:12:42 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: Black Agnes

I’ve noticed over the past ten years that those receiving cancer diagnoses are getting younger and younger. I have a 27 year od co-worker and new mommy just diagnosed with thyroid cancer. One of my husband’s coworker’s sons, three years old, had a testicle removed due to cancer. My mother-in-law goes to church with a nine year old who is dying from ovarian cancer. Cancer is no longer the disease we get if we live long enough.


6 posted on 08/04/2013 8:14:15 AM PDT by goodwithagun (My gun has killed fewer people than Ted Kennedy's car.)
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To: Innovative

Over treatment? Yes, with some types of cancer.

Over diagnosis? Smells like a socialized medicine death panel decision.


7 posted on 08/04/2013 8:15:09 AM PDT by SampleMan (Feral Humans are the refuse of socialism.)
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To: Innovative

Experts warn of dangers of overdiagnosis and treatment of cancer

http://articles.washingtonpost.com/2013-07-29/national/40887464_1_lung-cancer-ductal-carcinoma-overdiagnosis

“Improved screening has resulted in the overdiagnosis and overtreatment of cancers that are not life-threatening, without significantly reducing the death rate from the disease, and the time has come to alter how cancer is detected, treated and defined, a panel of medical experts said Monday.”


8 posted on 08/04/2013 8:18:54 AM PDT by Innovative ("Winning isn't everything, it's the only thing." -- Vince Lombardi)
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To: goodwithagun

When I was growing up my ‘class’ was about 200 kids. Ditto the year ahead of me and the year behind me. None of us (~600+) received a cancer diagnosis before we graduated.

Now, the local elementary has 2 or 3 kids every YEAR who are diagnosed with some sort of cancer. Brain tumors, leukemia, lymphomas, etc.

I’m sure those were just ‘missed’ diagnoses in my day.


9 posted on 08/04/2013 8:20:21 AM PDT by Black Agnes
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To: Innovative

In many cases the cure is worse than the condition.


10 posted on 08/04/2013 8:22:20 AM PDT by Mr Ramsbotham (I'll retire to Bedlam.)
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To: Innovative

Let me put it a different way.

Why are so many MORE people being diagnosed with cancer than 30 years ago? Including kids. I fail to believe these people would be ‘OK’ if we just didn’t diagnose that brain tumor or pancreatic cancer.

And then there’s this paper:

http://www.ncbi.nlm.nih.gov/pubmed/23756170 , “Glyphosate induces human breast cancer cells growth via estrogen receptors.” From the paper, it does so in parts per TRILLION. That’s amazing if true.


11 posted on 08/04/2013 8:22:24 AM PDT by Black Agnes
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To: Mr Ramsbotham

We’ll let you wait out that suspicious lump in your junk then. I’m sure if you wait 6m it’ll be OK or just go away.

Let us know how that turns out...


12 posted on 08/04/2013 8:23:32 AM PDT by Black Agnes
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To: Innovative

So...in other words, I should have just said “Naah, I’ll wait till my stage 3c breast cancer with 11 lymph node involvement just go till it’s REALLY serious”? Cos, ya know, it was found during a YEARLY mammogram...and it was the fast growing kind. Shoulda just waited till it showed up somewhere else...like when you tell your mom you’re too sick to go to school, and she doesn’t believe you till she SEES ya puke? Like that?

The problem is, people’s cancers are being found earlier, treated earlier, and the people go on to live longer lives. Longer lives, in this Adminstration of ObamaOcracy, are not encouraged. In fact, in some cases, they are just ended.


13 posted on 08/04/2013 8:28:15 AM PDT by blu
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To: Innovative
when you have early detection, you can't tell whether it will progress fast or slowly

While I agree with your point that the real motive here is rationing health care a la ObamaCare, I disagree with the above statement.

Generally, that can be determined by the analysis of the cancer cells.

14 posted on 08/04/2013 8:31:54 AM PDT by ChildOfThe60s (If you can remember the 60s.....you weren't really there)
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To: Innovative
do you have cancer then?
15 posted on 08/04/2013 8:32:58 AM PDT by Drawn7979
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To: goodwithagun

Maybe it has to do with compromised immune systems?


16 posted on 08/04/2013 8:34:00 AM PDT by dhs12345
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To: Innovative

The medicine propaganda has begun. Just give us your money, we’ll tell you if you need treatment or not. By taking medicine out of the “Free Market” and handing it over to the DMV like bureaucratic organization that is controlled by the IRS there is no reason to worry about treatment.


17 posted on 08/04/2013 8:42:55 AM PDT by Utah Binger (Southern Utah where the world comes to see America)
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To: Innovative
On a side note: how much total money and how many manhours have been spent on Cancer research? Billions of dollars? Millions of hours?

And how much has the treatment technology improved?

Seems like the treatments are fine tuned versions of the “sledgehammer” treatments of 20/30 years ago — chemo and radiation.

For all of the money and resources spent, we don't seem to have made a lot of progress. It doesn't leave me with a great deal of confidence in the medical system. Maybe I am wrong?

18 posted on 08/04/2013 8:43:25 AM PDT by dhs12345
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To: dhs12345

I don’t really know. I’ve been labeled a hippie here for my take (poor diet and nutrition, exposure to too many chemicals), but the truth of the matter is that doctors don’t know either.


19 posted on 08/04/2013 8:43:37 AM PDT by goodwithagun (My gun has killed fewer people than Ted Kennedy's car.)
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To: Mr Ramsbotham

I understand your sentiment but please please tread very carefully with this topic. Often times these special diets and remedies some people ascribe to leads to an even quicker death than chemo and such. Not flaming you, but trying to put some of these things in perspective. Cancer is an incredibly complicated thing.


20 posted on 08/04/2013 8:49:21 AM PDT by cornfedcowboy
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