Are we overdiagnosing the worried well?

NHS Choices comments on a powerfully argued and controversial paper in the British Medical Journal that claims many people are being diagnosed and treated for mild health problems that left alone might never cause any harm.

The magazine lists the common conditions that the authors claim are being overdiagnosed:

Breast cancer — a systematic review suggests that a third of breast cancers detected by screening might not cause harm or early death.

Thyroid cancer — detecting thyroid abnormalities is common, but risk low.

Gestational diabetes — an expanded definition means one in five pregnant women are diagnosed inappropriately.

Chronic kidney disease — an expanded definition means 10% of Americans are classified as having the disease but fewer than 1 in 1000 will develop end-stage kidney disease.

Asthma — asthma is often underdiagnosed, but a third of those being treated may not have the condition.

Pulmonary embolism — potentially fatal but new, sensitive tests detect smaller clots that may not require treatment.

Attention deficit hyperactivity disorder (ADHD) — a widened definition of this condition has led to overdiagnosis

Osteoporosis — expanded definitions means many women being treated even if at low risk of fractures.

Prostate cancer — Prostate specific antigen (PSA) may lead to overdiagnosis in more than 60% of men.

High blood pressure — authors suggest “substantial overdiagnosis” of high blood pressure.

High cholesterol — almost 4 in ever 5 people treated for high cholesterol may actually have near-normal cholesterol levels.

You can read the full assessment of the BMJ paper in NHS Choices.