# Modern autopsy studies to measure how much silent cancer people carry

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

## TL;DR

Autopsy studies decades ago found hidden prostate, thyroid and breast cancers in people who died of other causes, but they pre-date modern pathology. Repeating them with whole-body imaging and standardised histology would measure the reservoir of harmless cancer that every overdiagnosis estimate depends on.

## Summary

Overdiagnosis estimates depend on knowing the prevalence of indolent disease, yet the data is decades old and pre-dates modern pathology. Propose systematic autopsy series with whole-body imaging and standardised histology across ages and populations, quantifying the reservoir for prostate, thyroid, breast, kidney, lung and pancreas.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Modern reservoir estimates show at least 30% prevalence of indolent cancers in adults over 60 for several organs, changing screening threshold calculations.
- Rationale: MCED and imaging screening will find these lesions; we need to know how many there are before deciding what to call them.
- Proposed test: Fund 2,000 autopsies across five countries.
- Maturity: speculative
- Actor: research

## Sources

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

## Connected records

- cancers: [Prostate cancer](https://onco.cc/cancers/prostate/), [Thyroid cancer](https://onco.cc/cancers/thyroid/)
- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- bottlenecks: [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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