What's in a name? Well, there could be clinical benefits if physicians stop referring to small abnormalities with little chance of developing into life-threatening cancers as "cancer" or "carcinoma," according to a study group convened by the National Cancer Center.
In a viewpoint published online this week in the Journal of the American Medical Association, the group says improved screening has significantly increased detection of early stage disease without a producing a parallel decrease in late-stage disease, especially in breast, lung, prostate and thyroid cancer.
Thus, they suggest doctors and patients recognize that overdiagnosis is common, identify as cancer only lesions with a "reasonable likelihood of lethal progression if left untreated," and create registries for lesions with low potential for becoming malignancies to better inform decisions on treatment.
They also suggest developing strategies to "reduce detection of indolent disease," including less-frequent screening, focusing screening on high-risk populations, and raising the thresholds for conducting biopsies.
Better screening such as computer-aided detection (CAD) doesn't just find more non-invasive cancers, a separate study found. The "expensive technology" also results in more false-positive findings in breast cancer screenings, says Joshua Fenton, M.D., of the University of California at Davis.
"Our study suggests that we still don't know whether the benefits outweigh the harms for the average woman on Medicare," he says.
- read the commentary