Overdiagnosis
Finding a cancer that would never have caused symptoms or death in a person's lifetime, so that the diagnosis and treatment bring harm without benefit. It is the main downside of screening.
Overview
Overdiagnosis is invisible to the individual: a screen-detected cancer is treated and the person is cured of a disease that would not have hurt them. It is measured at population level as the excess incidence in a screened group that is never matched by a deficit later. Estimates are around 10-20% of screen-detected breast cancers in most reviews (the UK Independent Breast Screening Review put it at about 19%), a large share of PSA-detected low-grade prostate cancers before MRI-first pathways, and much of the rise in thyroid cancer and thin melanoma incidence. Remedies include raising thresholds (MRI-first prostate screening, Lung-RADS), renaming indolent lesions, and active surveillance rather than treatment. Multi-cancer blood tests raise the same question for cancers with no screening today.
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