Overdiagnosed Quotes

“I am often asked about three assumed benefits of mammography: less metastatic disease, less need for aggressive treatments, and important reassurance. Unfortunately, reviewing the actual evidence suggests that these “benefits” are limited or nonexistent.”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“Of course, different people will have different approaches to life. And individuals may feel differently about different diseases—particularly if some specific disease runs in the family.7 Adding to that variability is the fact that people may feel differently at different points in life. When we have major responsibilities to others, such as young children, we are likely to place more value on the “staying alive” side of the equation. But later in life, we may place more value on “staying well.” So we should expect that people will make different decisions about early diagnosis and that individuals’ decisions may change over time. In short, there is no single right answer.”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“To the extent that I have control over my cause of death, avoiding a heart-disease death, an aneurysm death, or a cancer death isn’t my top priority. I’m more concerned about suffering a lingering cognitive decline in a long-term-care facility. And”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“In 1996, the U.S. Preventive Services Task Force, the independent panel of experts that reviews screening tests, recommended against routine fetal monitoring.5 But according to their current Web site, fetal monitoring has become such an ingrained fixture of medical care that, frankly, the task force seems to have simply given up on trying to dissuade doctors from using it: Despite the lack of evidence on its positive impact on health outcomes and the 1996 USPSTF recommendation against its routine use, intrapartum electronic fetal monitoring in pregnancy has become common practice in the U.S. Based on currently available evidence, the USPSTF believes there would be limited potential impact on clinical practice in updating the 1996 recommendation. The”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“Patients could help by being a little less enthusiastic about scanning in general. In particular, they should avoid whole-body scans, which can open a Pandora’s box of incidentalomas. They could also be a little more hesitant about other scans and, when given the choice, choose the most anatomically focused exam to avoid stumbling onto things outside of the area of interest. A”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“Of course, I’m guilty of oversimplification here. First, there are real-world legal concerns: doctors aren’t punished for overdiagnosis, but they are punished for failing to diagnose. So it’s hard for doctors to ignore incidentalomas. Second,”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“Of course, that’s crazy. Doll and Hill’s data from over fifty years ago are equally relevant today—no matter how or where we study the issue, the finding is the same: smokers are ten to thirty times more likely to die from lung cancer than nonsmokers. This makes smoking the most powerful modifiable risk factor for cancers that kill people. Spiral CT technology is detecting a very different category of lung cancer, small abnormalities that meet the pathologic criteria for lung cancer yet are not destined to cause symptoms or death. Spiral CT is causing a substantial amount of overdiagnosis.”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“The right half of the table shows you data from 2001 on spiral CT screening on more than five thousand volunteers, some of whom smoked, some of whom did not.13 This study measured the rate of lung cancer diagnosis in smokers and nonsmokers. What it shows you is that with the advent of spiral CT, nonsmokers have about the same risk of lung cancer as smokers. It sure looks like the use of spiral CT has made cigarette smoking much better for you.”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“The United States is one of only two countries in the world that allow direct-to-consumer advertising of prescription drugs”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“The only way to know if the screening is saving lives is by doing a randomized trial. It's easy to forget this and assume that if technology can find more cancer, it will save more lives. Marketers exploit this assumption. Don't fall for it.”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health

“Given the number of small cancers they did find and the number that they reasoned they had missed...the researchers concluded that virtually everybody would have some evidence of thyroid cancer if examined carefully enough.”
― H. Gilbert Welch, Overdiagnosed: Making People Sick in the Pursuit of Health