Overdiagnosis in cancer screening refers to the detection of cancers that would never have caused symptoms or death if left undetected. This is MOST problematic in the screening of which cancer?

• A Pancreatic cancer
• B Colorectal cancer (FOBT screening)
• C Prostate cancer (PSA screening) ✓
• D Breast cancer in high-risk BRCA mutation carriers

Explanation

Overdiagnosis is most extensively documented and debated in PSA-based prostate cancer screening. Autopsy studies show that 30-70% of elderly men have histologically detectable prostate cancer that was clinically silent throughout life. PSA screening detects many of these indolent cancers, leading to unnecessary diagnosis, anxiety, and treatment (radical prostatectomy, radiation) with associated morbidity. Estimates suggest 20-50% of PSA-detected prostate cancers represent overdiagnosis. This has led major organizations (USPSTF) to recommend against routine PSA screening in average-risk men. Overdiagnosis is less of a concern for pancreatic cancer (usually detected late) or BRCA carriers (high-risk group).

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.