Thyroid cancer overdiagnosis: the ethical issues

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Concise title: Overdiagnosis: the ethical issues.

Overdiagnosis refers to the detection of conditions that, if left undiagnosed and untreated, would not proceed to cause symptoms or death for the affected individual. Overdiagnosis leads to harms rather than benefits for patients and for society. Several factors contribute to overdiagnosis, including the lowering of diagnostic thresholds, increasing use of highly sensitive tests and expansion of screening activities. These factors are exacerbated by financial conflicts of interests and intolerance of uncertainty. Overdiagnosis of papillary thyroid cancer is internationally recognised as a problem and leads to considerable harms to patients.
Overdiagnosis raises several ethical issues, ranging from harm to patients and compromised patient autonomy through to waste of health care resources, conflicts of interest and loss of trust in the patient-doctor relationship. Individuals who are overdiagnosed receive no benefits and may suffer significant harms. They are made into patients unnecessarily, because their condition does not require treatment. The consequences of being overdiagnosed can include physical, psychological, social and economic burdens.
Strategies to address thyroid cancer overdiagnosis include risk stratification and the development of better communication resources.
Original languageEnglish
Pages (from-to)16-21
Number of pages6
JournalJournal of the Japan Thyroid Association
Issue number1
Publication statusPublished - Apr 2021


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