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Estimating the magnitude of cancer overdiagnosis in Australia

Diana L Learoyd
Med J Aust 2020; 213 (4) || doi: 10.5694/mja2.50575
Published online: 17 August 2020

To the Editor: The issue of cancer overdiagnosis highlighted by Glasziou and colleagues1 is not new. The problem lies in how clinicians translate caution into the care of individual patients.

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  • University of Sydney, Sydney, NSW


Correspondence: diana.learoyd@sydney.edu.au

Competing interests:

No relevant disclosures.

  • 1. Glasziou PP, Jones MA, Pathirana T, et al. Estimating the magnitude of cancer overdiagnosis in Australia. Med J Aust 2020; 212: 163–168. https://www.mja.com.au/journal/2020/212/4/estimating-magnitude-cancer-overdiagnosis-australia
  • 2. Beral V, Peto R, Pirie K, Reeves G. Menopausal hormone therapy and 20 year breast cancer mortality. Lancet 2019; 394: 1139.
  • 3. Australian Institute of Health and Welfare. Breast screen Australia monitoring report 2018 [Cancer series 112; Cat. No. CAN116]. Canberra: AIHW, 2018. https://www.aihw.gov.au/getmedia/c28cd408-de89-454f-9dd0-ee99e9163567/aihw-can-116.pdf.aspx?inline=true (viewed Mar 2020).
  • 4. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016; 26: 1–133.
  • 5. McLeod DSA, Zhang L, Durante C, Cooper DS. Contemporary debates in adult papillary thyroid cancer management. Endocr Rev 2019; 40: 1481–1499.
  • 6. Royal Australasian College of Physicians, Endocrine Society of Australia. EVOLVE programme: top 5 low‐value practices and interventions — recommendation 1. RACP/ESA, 2017. https://evolve.edu.au/recommendations/esa (viewed Mar 2020).
  • 7. Grani G, Lamartina L, Ascoli V, et al. Reducing the number of unnecessary thyroid biopsies while improving diagnostic accuracy: toward the “right” TIRADS. J Clin Endocrinol Metab 2019; 104: 95–102.
  • 8. Lin JF, Jonker PKC, Cunich M, et al. Surgery alone for papillary thyroid microcarcinoma is less costly and more effective than long term active surveillance. Surgery 2020 Jan; 167: 110–116.

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