# Every screening programme must publish its overdiagnosis rate each year

Source: https://onco.cc/ideas/idea-prev-annual-overdiagnosis-reporting/  
OnCo record `idea-prev-annual-overdiagnosis-reporting` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Screening finds cancers that would never have caused harm, but programmes only report cancers found. Publishing the estimated overdiagnosis rate alongside would make the trade-off visible.

## Summary

Overdiagnosis is estimable from excess cumulative incidence versus unscreened comparators and from modelling. Propose a regulatory requirement for annual reporting of estimated overdiagnosis, false positives, and procedures per cancer, in standard formats, for every publicly funded screening programme and any reimbursed MCED.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Mandatory reporting drives programme changes (thresholds, intervals) that reduce overdiagnosis by at least 20% within five years without reducing advanced-cancer detection.
- Rationale: Current metrics reward detection volume; what is measured is managed.
- Proposed test: Adopt in one country; compare programme changes with non-adopters.
- Maturity: speculative
- Actor: regulator

## Sources

- Bottleneck evidence (Overdiagnosis and false alarms): Welch & Black, Overdiagnosis in cancer (JNCI 2010): https://doi.org/10.1093/jnci/djq099

## Connected records

- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- terms: [Positive predictive value (PPV)](https://onco.cc/terms/ppv/)
- bottlenecks: [Incentives reward me-too drugs and marginal gains](https://onco.cc/bottlenecks/b-incentive-misalignment/), [Overdiagnosis and false alarms](https://onco.cc/bottlenecks/b-overdiagnosis/)
- key papers: [Overdiagnosis in cancer](https://onco.cc/key-papers/paper-welch-j-natl-cancer-inst/)

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