The case against early oncological diagnosis was the title of an article that called into question the very system of modern oncology. It first appeared in 2014 – and at the same time, some Russian oncologists supported the idea: early detection of cancer quite often only leads to the fact that you know about your diagnosis longer and live in fear longer. And that’s half the trouble. Early diagnosis often results in overdiagnosis and leads to unnecessary surgeries/chemotherapy/irradiation, which, of course, worsen the quality of life. Now the well-publicized phenomenon “In the US, 98% of women with early breast cancer are cured” doesn’t seem so convincing: were they all really sick?
What is overdiagnosis
Christie Aschwanden, the author of the sensational article, does not immediately undertake to come into conflict with the American healthcare system, therefore she analyzes the situation using the example of South Korea. There has always been widespread thyroid cancer. And South Korea is a country of high technologies. Including in medicine. Therefore, since 1999, free screening of the population for thyroid cancer has begun in the country. Since then (that is, in less than 20 years), cancer incidence has increased 15 times. Luckily, Koreans didn’t get sick more often — they just got diagnosed earlier and more often. It’s good. It would be… If at the same time the statistics of mortality from thyroid cancer would decrease. But no! Mortality remained at the same level.
As you know, whoever seeks will always find. We look for cancer, we find cancer. After the publication of materials on the South Korean phenomenon, they finally started talking about overdiagnosis. This is not as harmless as it might seem at first glance. Most people diagnosed with thyroid cancer simply have their thyroid gland removed, leaving them on hormone replacement therapy for the rest of their lives. That is, their quality of life deteriorates significantly compared to those who did not undergo screening and did not start “on time for treatment”, and the chances of surviving to old age are approximately equal for both.