Avoid being over-diagnosed, and over-treated

The concept of over-diagnosis may be foreign to most patients, and even doctors too. Over-diagnosis refers to making a diagnosis that is ultimately not necessary, because the patient would never have suffered any symptoms or death from the said diagnosis.Over-diagnosis usually occurs when you get screened for a disease, such as cancer, in an effort to detect it at an early stage when it may be more amenable to treatment and cure.

The screening process may detect something innocuous which may be clinically insignificant. You then end up with some form of treatment whose outcome may be worse off than harboring the said disease. Autopsy studies from patients who have died from other conditions give us a sobering realization of over-diagnosis and over-treatment. Some data already shows that 1in 2 prostate cancers in men, and 1 in 3 breast cancers in women are over-diagnosed. Such individuals end up with treatments that may have been avoided, sometimes suffering unwanted harm or even death.

Whose duty is it to try and avoid over-diagnosis?

The responsibility lies between you and your physician. Let’s start with your physician first. They owe you a duty to provide you with the best of care. That means they must always be up to date with their knowledge, and practice what is referred to as evidence-based medicine. They must never go beyond the limits of their specialization, meaning that they must always be ready to refer you to the most appropriate colleague. Any tests and interventions proposed must always be objective.Temptations to correct mundane symptoms and coincidental but insignificant diagnoses must be avoided at all costs.

And your role?

You need as much information as you can get when subjecting yourself to screening tests. When told a certain result is anything but negative, it is your duty to understand what that really means. You do this by engaging with your physician, and asking direct questions. Don’t get satisfied with vague answers, ask for clarifications or seek second opinions. This is more so if you are relatively well, and some treatment is being suggested which is not entirely risk-free. Decisions on any interventions cannot just be made by your physician alone, it must be a shared decision between you and them.

Far too many of us harbor certain stuff in our bodies which are completely irrelevant in the grand scheme of ongoing health. And too many people get multitudes of tests that are of unproven value, leading to unnecessary anxiety and even unwarranted treatments. The equation in medical interventions must always favor benefits, and avoid harm through misdirected treatments. True, you want to be in the best state of health, but that does not mean getting over-diagnosed and over-treated for the sake of it. Find a way of getting the right balance, and only ever accept treatment that is absolutely necessary.

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