Income and Cancer Overdiagnosis — When Too Much Care Is Harmful — NEJM: Perspective from The New England Journal of Medicine — Income and Cancer Overdiagnosis — When Too Much Care Is Harmful
This article explores the concern that over-diagnosis leads to potentially harmful treatment especially in cancers that are known to be slow growing. Over-diagnosis is associated wtih income levels: the greater the income, the more over-diagnosing which the authors of the article state causes an "observational intensity" leading to more lab work, more scans, more procedures etc.
What I found interesting is that there are four cancers that are subject to observational intensity: breast, prostate, melanoma and thyroid. "The combined incidence of these cancers has been rising in all U.S. counties but there hasn't been an increase in cancer-specific mortality..." The combined cancer mortality is similar in high-income and low-income counties in these four cancers. In fact, the cancer mortality has been decreasing especially in breast and prostate cancers which is attributed to better treatments. "Too little medical care needs to be balanced with a concern about too much."