Over-diagnosis ‘wasting resources on unnecessary care’

Experts concerned healthy people being labelled 'sick'

Diagnosis and treatment for conditions that will never cause people harm is a growing threat to health as it wastes resources that could be better used elsewhere, experts are claiming.

In an article published on the British Medical Journal’s (BMJ’s) website this week, Ray Moynihan, senior research fellow at Bond University in Australia, described over-diagnosis as a “significant threat” to human health.

Moynihan said: “As evidence mounts that we’re harming the healthy, concern about over-diagnosis is giving way to concerted action on how to prevent it.”

Evidence given for the claim that over-diagnosis is on the rise includes a large Canadian study which found that almost a third of people diagnosed with asthma may not have the condition, as well as a systematic review suggesting that up to one in three breast cancers detected by screening may be over-diagnosed.

Furthermore, some researchers argue that osteoporosis treatments may do more harm than good for women at very low risk of future fracture.

Moynihan and other co-authors of the BMJ article, including Dr David Henry, chief executive officer of the Institute for Clinical Evaluative Sciences, argue that many factors are driving over-diagnosis, including commercial and professional vested interests, legal incentives and cultural issues.

They claim that ever-more sensitive tests are detecting tiny “abnormalities” that will never progress into harmful conditions, while widening disease definitions and lowering treatment thresholds mean people at ever lower risks receive diagnosis and treatment that many will fail to benefit from.

Professor Paul Glasziou, from Bond University in Australia, said: “As a side effect of our improving diagnostic technology, over-diagnosis is a rapidly growing problem; we must take it seriously now or suffer the consequences of overtreatment and rising health care waste.”

An international conference, Preventing Over-diagnosis, is to be held on the topic in September 2013, hosted by The Dartmouth Institute for Health Policy and Clinical Practice, in partnership with the BMJ, the consumer organisation Consumer Reports and Bond University, Australia.

Fiona Godlee, editor-in-chief at the BMJ, said: "The harm of over-diagnosis to individuals and the cost to health systems is becoming ever clearer. Far less clear is what we should do about it.

“Next year's conference is an important step towards some evidence-based solutions."

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