Every screening programme must publish its overdiagnosis rate each year
Screening finds cancers that would never have caused harm, but programmes only report cancers found. Publishing the estimated overdiagnosis rate alongside would make the trade-off visible.
Overdiagnosis is estimable from excess cumulative incidence versus unscreened comparators and from modelling. Propose a regulatory requirement for annual reporting of estimated overdiagnosis, false positives, and procedures per cancer, in standard formats, for every publicly funded screening programme and any reimbursed MCED.
- Overdiagnosis and false alarms · Finding more cancer is not the same as saving lives. Screening also finds cancers that would never have hurt anyone, and treats them.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
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