Rates of Breast Cancer Overdiagnosis May Be Lower Than Other Studies Estimate
New BCSC study projects an overdiagnosis rate of 15% using estimates of the frequency of non-progressive disease and the asymptomatic duration of those who become symptomatic
A new BCSC study in Annals of Internal Medicine offers a new estimate of the extent of breast cancer overdiagnosis in contemporary US practice. The new estimate, using data from the Breast Cancer Surveillance Consortium is much lower than cited by previous studies.
Previous studies suggested that overdiagnosis rates could account for close to one in three cases of breast cancer diagnosed in the United States, which led to media coverage emphasizing the harms and risks of overdiagnosis and confusing patients and providers alike. Such studies summarized an overall average duration of cancers that remained asymptomatic without accounting for cancers that never display symptoms. This new BCSC study utilizes BCSC data to examine the frequency of non-progressive disease and the asymptomatic duration among those destined to become symptomatic. The results are an estimated overdiagnosis rate of 15%- approximately one in seven- overdiagnosis in women 50-74 years of age enrolled in biennial screening. The estimate for annual screening is comparable. The authors also find that overdiagnosis rates above 25% are highly unlikely.
In a video accompanying the publication of the study Ryser states, “I hope that our overdiagnosis estimate of 15% among screen-detected cases will be adopted as a new standard and will lead to better informed decision making around breast cancer screening, follow-up testing, and treatment.”
Ryser MD, Lange J, Inoue L, O’Meara ES, Gard C, Miglioretti DL, Bulliard J-L, Brouwer AF, Hwang ES, Etzioni R. Estimation of Breast Cancer Overdiagnosis in a US Breast Screening Cohort. Ann Intern Med. In Press. https://doi.org/10.7326/M21-3577 [Link]
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Posted by: Xoe Amer