MASSDEVICE ON CALL — Over-diagnosis – when patients are diagnosed and treated for conditions that will never cause them harm – is a growing problem that may have repercussions for patients and economies of care, Australian researchers said.

The researchers cited a Canadian study which found that almost a third of patients diagnosed with asthma likely didn’t have the condition. They also noted figures suggesting that 1 in 3 breast cancers detected through screenings may be over-diagnosed.

Factors driving over-diagnosis range from commercial and professional interests to legal incentives and cultural issues, researchers said, and may be exacerbated by ever-more-sensitive diagnostic tools that detect "abnormalities" that will never progress but receive lifelong treatment.

"Increasingly we’ve come to regard simply being ‘at risk’ of future disease as being a disease in its own right," senior researcher Ray Moynihan said in prepared remarks. "As evidence mounts that we’re harming the healthy, concern about over-diagnosis is giving way to concerted action on how to prevent it."

Treatment not only affects patients’ health, it puts financial pressure on health systems that are already overburdened, and money spent unnecessarily treated perceived conditions would be better spent providing care for those without sufficient access to needed medicine, researchers added.

"It took many years for doctors to accept that bacteria caused peptic ulcers," co-author and CEO of the Institute for Clinical Evaluative Sciences Dr. David Henry said in prepared remarks. "Likewise, it will be hard for doctors and the public to recognize that the earliest detection of disease is not always in the best interests of patients."

The research comes on the heels of widespread fury over a U.S. Preventative Services Task Force recommendation that physicians set aside a commonly used prostate cancer screening tool. The panel was concerned about the dangers of aggressive prostate cancer treatment in patients who are asymptomatic and whose cancer may have remained neutral without intervention.

Primary care physicians surveyed by Johns Hopkins University said they were unlikely to change their testing habits in reaction to the panel’s guidance.

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