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. 2014 Oct 31;106(12):dju315.
doi: 10.1093/jnci/dju315. Print 2014 Dec.

A reality check for overdiagnosis estimates associated with breast cancer screening

Ruth Etzioni  1 , Jing Xia  2 , Rebecca Hubbard  2 , Noel S Weiss  2 , Roman Gulati  2
Affiliations

A reality check for overdiagnosis estimates associated with breast cancer screening

Ruth Etzioni et al. J Natl Cancer Inst. .

Abstract

The frequency of overdiagnosis associated with breast cancer screening is a topic of controversy. Published estimates vary widely, but identifying which estimates are reliable is challenging. In this article we present an approach that provides a check on these estimates. Our approach leverages the close link between overdiagnosis and lead time by identifying the average lead time most consistent with a given overdiagnosis frequency. We consider a high-profile study that suggested that 31% of breast cancers diagnosed in the United States in 2008 were overdiagnosed and show that this corresponds to an average lead time of about nine years among localized cases. Comparing this estimate with the average lead time for invasive, screen-detected breast cancers of 40 months, around which there is a relative consensus, suggests the published estimate of overdiagnosis is excessive. This approach provides a novel way to appraise estimates of overdiagnosis given knowledge of disease natural history.

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Comment in

  • Lead time and overdiagnosis.
    Baker SG, Prorok PC, Kramer BS. Baker SG, et al. J Natl Cancer Inst. 2014 Oct 31;106(12):dju346. doi: 10.1093/jnci/dju346. Print 2014 Dec. J Natl Cancer Inst. 2014. PMID: 25362702 No abstract available.

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