Overdiagnosed by H. Gilbert Welch, Lisa Schwartz, and Steven Woloshin

Subtitle: Making People Sick in the Pursuit of Health

Published: 2011

Genre: medical nonfiction

Length: 193 pages

Interest: I had heard an interview with the lead author on Science Friday, and took notes, so when I saw the book at the library, I picked it up. I knew the material would be perfect for the cancer lecture coming up in one of my classes.

Summary: The authors first discuss what overdiagnosis is (identifying something as a problem, and treating it as such when it would never actually cause a health issue). They then go into how overdiagnosis occurs: because we change the cutoff of what is normal or diseased (seen with high blood pressure, high cholesterol, diabetes, osteoporosis, among others), or we improve the technology so we can find smaller and smaller imperfections (seen with many cancers or prenatal screenings). Basically, they are pushing back against the concept that finding and treating something early is always the best option.

Final thoughts: Really a fascinating book that made an excellent case for overdiagnosis and the harm it does our society, both in terms of monetary costs, as well as emotional stress. It certainly makes me think twice about getting a mammogram at 40, as well as the usefulness of preventative checkups. The best part for me was the author was able to back up his claims with numbers: for every 2000 women who get a mammogram for 10 years, you avoid 1 death, but diagnose and treat 10 healthy women for cancer and about 200 will get an abnormal reading. Sure, that one person is extremely grateful, but what about the ten others with nasty side effects from treatment, let alone the trauma of the 200 with abnormal readings. Really makes you wonder!

Title comes from: The premise of the book.


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