Feig Stephen A
Breast Cancer Res. 2013;15(4):105. doi: 10.1186/bcr3448.
Stories in the public media that 30 to 50% of screen-detected breast cancers are overdiagnosed dissuade women from being screened because overdiagnosed cancers would never result in death if undetected yet do result in unnecessary treatment. However, such concerns are unwarranted because the frequency of overdiagnosis, when properly calculated, is only 0 to 5%. In the previous issue of Breast Cancer Research, Duffy and Parmar report that accurate estimation of the rate of overdiagnosis recognizes the effect of lead time on detection rates and the consequent requirement for an adequate number of years of follow-up. These indispensable elements were absent from highly publicized studies that overestimated the frequency of overdiagnosis.
公共媒体上的报道称，通过筛查发现的乳腺癌中有30%至50%属于过度诊断，这让女性不愿接受筛查，因为过度诊断出的癌症如果未被发现就永远不会导致死亡，但却会导致不必要的治疗。然而，这种担忧是没有根据的，因为经过正确计算，过度诊断的发生率仅为0%至5%。在上一期的《乳腺癌研究》中，达菲和帕尔马报告称，对过度诊断率的准确估计认识到了提前期对检出率的影响以及随之而来的对足够多年随访的要求。那些高估过度诊断发生率且广为人知的研究中缺少这些不可或缺的因素。
