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Medical Researchers Raise Alarm on Over-Diagnosis

U.S. conference scheduled for September (Feb. 27)

The British Medical Journal (BMJ) has launched a campaign against over-diagnosis, where people are diagnosed with medical conditions they don’t have and are prescribed medicines they don’t need.

The BMJ’s campaign, “Too Much Medicine,” aims to draw attention to a growing body of evidence that many people are over-diagnosed and over-treated for conditions such as prostate and thyroid cancers, asthma, and chronic kidney disease.

“Like the evidence-based medicine and quality and safety movements of previous decades, combating excess is a contemporary manifestation of a much older desire to avoid doing harm when we try to help or heal,” said BMJ editor Dr. Fiona Godlee.

Over-diagnosis wastes vast amounts of money every year, and new research is urgently needed on how clinicians can scale back the numbers of medications being taken unnecessarily, said Ray Moynihan, a senior researcher at Bond University in Australia.

The university and BMJ — in partnership with the Dartmouth Institute for Health Policy and Clinical Practice and Consumer Reports — are co-hosting an international conference on the issue, called “Preventing Overdiagnosis,” to be held in the U.S. in September.

Moynihan said further research was needed into the possibility than many of the normal aspects of ageing were a source of over-diagnosis.

“I think part of the problem is that too many of the normal processes of ordinary life are being transformed into the symptoms of medical conditions. I think this campaign is about bringing attention to that problem,” he said.

According to Moynihan, previous studies have found that up to a third of screening-detected breast cancers may be over-diagnosed and that there is a 60% chance that a cancer detected by prostate-specific antigen (PSA) testing will be over-diagnosed. Moreover, a 2008 Canadian study found that 30% of people diagnosed with asthma in a research sample group did not have the condition.

“Over-diagnosis and over-treatment are the biggest problems facing doctors and patients in the next decade as they try to make good decisions about health care,” said Dr. Dee Mangin. “It creates illness in otherwise well patients as well as adding to the burden of those who are already ill.”

Among the drivers of the problem are an ageing population concerned with staying healthy for as long as possible and commercial imperatives of drug and diagnostic companies to provide profits for shareholders, she said.

Sources: The Conversation; February 27, 2013; and Preventing Overdiagnosis; 2013.

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