http://www.ncbi.nlm.nih.gov/pubmed/25992887PLoS One. 2015 May 20;10(5):e0125165. doi: 10.1371/journal.pone.0125165. eCollection 2015.
Public Opinions about Overdiagnosis: A National Community Survey.
Moynihan R1, Nickel B2, Hersch J2, Beller E1, Doust J1, Compton S3, Barratt A2, Bero L4, McCaffery K2.
1Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia.
2School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
3The Social Research Centre, Melbourne, Victoria, Australia.
4Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.
Despite evidence about the "modern epidemic" of overdiagnosis, and expanding disease definitions that medicalize more people, data are lacking on public views about these issues. Our objective was to measure public perceptions about overdiagnosis and views about financial ties of panels setting disease definitions.
We conducted a 15 minute Computer Assisted Telephone Interview with a randomly selected community sample of 500 Australians in January 2014. We iteratively developed and piloted a questionnaire, with a convenience sample (n=20), then with participants recruited by a research company (n=20). Questions included whether respondents had been informed about overdiagnosis; opinions on informing people; and views about financial ties among panels writing disease definitions.
Our sample was generally representative, but included a higher proportion of females and seniors, typical of similar surveys. American Association for Public Opinion Research response rate was 20% and cooperation rate was 44%. Only 10% (95% CI 8%-13%) of people reported ever being told about overdiagnosis by a doctor. 18% (95% CI 11%-28%) of men who reported having prostate cancer screening, and 10% (95% CI 6%-15%) of women who reported having mammography said they were told about overdiagnosis. 93% (95% CI 90%-95%) agreed along with screening benefits, people should be informed about overdiagnosis. On panels setting disease definitions, 78% (95% CI 74%-82%) felt ties to pharmaceutical companies inappropriate, and 91% (95% CI 82%-100%) believed panels should have a minority or no members with ties. Limitations included questionnaire novelty and complexity.
A small minority of Australians surveyed, including those reporting being screened for prostate or breast cancer, reported being informed of overdiagnosis; most believed people should be informed; and a majority felt it inappropriate that doctors with ties to pharmaceutical companies write disease definitions. Results suggest strategies to better inform people about overdiagnosis, and review disease definition processes, have significant public sympathy.
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Ignorancia voluntaria o amoralidad? En próstata y radiología de mama no informan a los pacientes sobre el riesgo de sobrediagnóstico y convertirlos en falsos pacientes de cancer. Cuando informar al paciente pone en riesgo lo que se cobra a fin de mes, pues viva el corporativismo. Esto es muy grave, pues es engañar a los pacientes valiéndose del poder que la sociedad confiando les dona. Es una traición a la sociedad y al propio juramento hipocrático.