Overdiagnosis—Incidentalomas

This is a series of key points from the 2013 book, Overdiagnosis, Making People Sick in the Pursuit of Health, by H. Gilbert Welch of the Dartmouth Institute for Health Policy. With the sophisticated CT scans, MRIs, Ultrasounds and other screening devices we are finding more and more incidental lesions that need follow-up testing and sometimes surgeries that are not only unnecessary but also might lead to considerable expense, anxiety, and even complications. Many cancers discovered before symptoms begin might have no impact on health or lifespan because they grow so slowly. They might not otherwise be discovered before you die of something else. PSA for prostate screening and CA-125 for ovarian cancer are markers that have been shown to have little or no benefit as far as extending life. There are a few screening tests that discover abnormalities that can be modified and thus make a difference. CardioRisk for carotid plaque, colonoscopy, and breast thermography are ones that I find very helpful, but the search for “incidentalomas” can do more harm than good. CardioRisk testing at Celebration of Health on September 30th Celebration of Health Association website