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Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database
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  • Published on: 28 April 2025
    Overdiagnosis: Misconceptions About Prostate and Breast Cancer Screening
    • Takeshi Takahashi, Public Health Physician (5yrs), Ex Urologic Surgeon (30yrs) Kitakyushu city

    Overdiagnosis occurs when a lesion is identified as cancer despite the absence of symptoms or subsequent cancer-related death. (1) This is particularly common in elderly patients with shorter follow-up periods, assuming the cancer diagnosis is accurate. For prostate and breast cancers, the natural history of screen-detected cases remains unverified, and many of these cancers remain asymptomatic or non-lethal even with extended observation. Therefore, the issue lies with the diagnostic tests, not the duration of observation. While it is accurate to state that "colorectal cancer screening results in overdiagnosis in the elderly," describing prostate cancer as having an overdiagnosis issue is misleading. Instead, it should be clarified that "the natural history of screen-detected prostate cancer has not been verified" or that "there are limitations in the diagnostic tests."
    Cancer is typically diagnosed by detecting the formation of a mass through endoscopy or imaging, followed by histopathological confirmation that the cells are malignant. However, screen-detected prostate and breast cancers do not form masses and are diagnosed based solely on histopathology. Whether a lesion diagnosed in this way is biologically cancerous—that is, its natural history—has not been clinically or scientifically verified. (2-4)
    In cancer statistics, both prostate and breast cancers rank among the highest in terms of incidence. (5) However, most of these...

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    Conflict of Interest:
    None declared.
  • Published on: 24 February 2025
    Absence of relationship between incidence and mortality can be explained by therapeutic improvements

    There have been significant therapeutic improvements for certain cancers. Although the increased incidence of thyroid cancer and prostate cancer can be entirely explained by detection, the increased incidence of breast cancer and melanoma is largely real (1-4), as shown by stratification of age groups based on mortality or incidence.
    1) Corcos D, 2017. Breast cancer incidence as a function of the number of previous mammograms: analysis of the NHS screening programme. BioRxiv doi.org/10.1101/238527
    2) Corcos D & Bleyer A, 2020. Epidemiologic signature in cancer: Prostate vs Breast. New England Journal of Medicine, 382(1):96
    3) Corcos D, 2020. 2nd International DKFZ Conference on Cancer Prevention
    4) Corcos D & Bleyer A, 2021. Cause of the Decades of Increase in Cutaneous Melanoma: Overdiagnosis, Ultraviolet Rays, Non-Ultraviolet Radiation? ResearchGate.

    Conflict of Interest:
    None declared.