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Cancer OverDiagnosis- Real or Not?

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Does cancer overdiagnosis actually occur? According to the ACS, cancer incidence rates were down during the pandemic. Meaning, fewer people were diagnosed with cancer in 2020 during the pandemic, than were diagnosed with cancer in 2019, the previous year.

Further, according to the ACS, “The declines were largely driven by local and regional stage disease…” meaning most of the declines in cancer diagnoses were for early stage cancers (stage 1, 2).

So the question is, what does this mean for society? I believe there are two things happening here.

  1. First, during the pandemic, people were, in general, staying home, not going to the hospital to undergo diagnostic testing. 
  2. Second, fewer diagnostic tests result in fewer early stage cancers being diagnosed. 

At this stage, it is difficult to say what will come of fewer, early stage cancer diagnoses occurring in 2020. After all, early stage cancer diagnoses are usually not a problem early on,  as they do not cause health problems for the patient at first.

What is Cancer OverDiagnosis?

Cancer overdiagnosis refers to the identification and diagnosis of cancers that, if left untreated, would not have caused symptoms or harm to the individual during their lifetime. In other words, it involves detecting and treating cancers that may not have progressed to the point of causing clinical problems or impacting a person’s health.

Overdiagnosis can occur due to advances in medical imaging technologies, increased cancer screening programs, and improved diagnostic methods. These advancements may lead to the detection of small or slow-growing tumors that may never become clinically significant or life-threatening. As a result, individuals may undergo unnecessary treatments, such as surgery, radiation therapy, or chemotherapy, exposing them to potential risks and side effects without providing substantial benefits.

Cancer overdiagnosis is a complex and controversial issue. While early detection is crucial for the successful treatment of some cancers, it is also important to balance the benefits of early detection with the potential harms of overdiagnosis and overtreatment. This dilemma has led to ongoing discussions in the medical community about refining screening guidelines and developing more personalized approaches to cancer diagnosis and treatment.

Two things will happen in the future-

I’m guessing here-  sometime in the future (5-10 years?), if, in general, cancer overdiagnosis occurs, nothing will happen. Meaning, tiny cancers that would not cause health problems, were not diagnosed in 2020.

If however, there is little if any true cancer overdiagnosis, there will be an up tick, a surge in cancer deaths due to the documented decrease in cancer incidence in 2020.

I am a long-term survivor of an incurable cancer called multiple myeloma. I have studied and written about my own cancer as well as the world of cancer since 2004. I have whitnessed cancer diagnostics do wonderful things for cancer patients and, at the same time, I have witnessed diagnostic, possibly go too far- aka overdiagnosis.

I apologize if I sound ghoulish here but I consider the pandemic to be a real world example of possible cancer overdiagnosis.  If I find a study in the future documenting an uptick in cancer deaths, I will write blog posts accordingly.

Are you a cancer patient or survivor who put off some sort of cancer screening during the pandemic and were diagnosed with some form of cancer, later? Do you have a real life example of postponing cancer screening during the pandemic only to realize later that you missed your chance to diagnose an early stage cancer?

Let me know- David.PeopleBeatingCancer@gmail.com


David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Cancer Incidence Rates Declined for Most Cancer Types During First Year of COVID-19

A new report led by researchers at the American Cancer Society (ACS) shows, during the first year of the COVID-19 pandemic, cancer incidence rates declined for almost all cancer types examined. The declines were largely driven by local and regional stage disease, however, cancer incidence rates for distant stage or the most advanced type of disease decreased for just six of the 22 cancer types examined…

“Cancer incidence rates during 2020 deviated from pre-pandemic patterns, likely due to the suspension of health care for both cancer and non-cancer related medical care,” said Elizabeth Schafer, associate scientist, health equity science at the American Cancer Society and lead author of the study. “These findings have given us more evidence of the impact of the pandemic on cancer incidence rates by stage at diagnosis and race and ethnicity…”

The study results showed, from 2019 to 2020, the incidence of local-stage disease declined for 19 of the 22 cancer types, ranging from 4% for urinary bladder cancer to 18% for colorectal and laryngeal cancers, deviating from pre-COVID stable year over-year changes. Incidence during the corresponding period also declined for 16 cancer types for regional-stage and six cancer types for distant-stage disease…

The decline in cancer incidence rates during the first year of the COVID-19 pandemic occurred mainly for local and regional-stage diseases across racial and ethnic groups…

“Whether these declines will lead to increases in advanced-stage disease and mortality rates remain to be investigated by studying the incidence and mortality trends with additional data years,” added Schafer…

Overdiagnosis: when finding cancer can do more harm than good

“Some (cancers) grow fast and spread quickly, while others grow so slowly (or even not at all) that if they went undetected they wouldn’t cause any problems. Even if left untreated, a person wouldn’t be harmed by their cancer.

When these harmless cancers are found they’re said to be ‘overdiagnosed’. This happens more often with certain types of cancer, and is usually tied to particular types of cancer screening that test people without symptoms, such as breast screening.

The problem is that when these types of cancer are diagnosed early it’s impossible to tell the potentially harmful ones from the harmless ones. Everyone is then usually offered treatment. And this means that some will be exposed to the potential side effects of treatment, and worry of a cancer diagnosis, when they didn’t need to be. This is called overtreatment…





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