Ericka M Sohlberg1, Thomas J Metzner2, John T Leppert3. 1. Department of Urology, Stanford University School of Medicine, Stanford, CA, USA. 2. Department of Urology, Stanford University School of Medicine, Stanford, CA, USA; The Stanford Kidney Cancer Research Program, Stanford, CA, USA. 3. Department of Urology, Stanford University School of Medicine, Stanford, CA, USA; The Stanford Kidney Cancer Research Program, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. Electronic address: jleppert@stanford.edu.
Abstract
Overdiagnosis and overtreatment refer to the detection and treatment of conditions that would not ultimately affect an individual's health. With increasing detection of small renal masses there is growing awareness of the overdiagnosis and overtreatment of these tumors, supported by studies showing that 15-30% of nephrectomy specimens are pathologically benign, and that many small renal cell carcinomas are indolent. The harms of overdiagnosis and overtreatment are numerous, including psychosocial stressors and renal morbidity, in addition to unnecessary surgical complications. A greater understanding of the potential harms of overdiagnosis and overtreatment is crucial as clinicians focus on optimizing patient selection for renal mass biopsy, active surveillance protocols, and minimally invasive surgery. PATIENT SUMMARY: In this mini-review we discuss the issues of overdiagnosis and overtreatment in patients with kidney cancer. We enumerate the risks of overdiagnosis and overtreatment, and examine the next steps towards preventing these harms. Published by Elsevier B.V.
Overdiagnosis and overtreatment refer to the detection and treatment of conditions that would not ultimately affect an individual's health. With increasing detection of small renal masses there is growing awareness of the overdiagnosis and overtreatment of these tumors, supported by studies showing that 15-30% of nephrectomy specimens are pathologically benign, and that many small renal cell carcinomas are indolent. The harms of overdiagnosis and overtreatment are numerous, including psychosocial stressors and renal morbidity, in addition to unnecessary surgical complications. A greater understanding of the potential harms of overdiagnosis and overtreatment is crucial as clinicians focus on optimizing patient selection for renal mass biopsy, active surveillance protocols, and minimally invasive surgery. PATIENT SUMMARY: In this mini-review we discuss the issues of overdiagnosis and overtreatment in patients with kidney cancer. We enumerate the risks of overdiagnosis and overtreatment, and examine the next steps towards preventing these harms. Published by Elsevier B.V.
Entities:
Keywords:
Kidney cancer; Overdiagnosis; Overtreatment; Renal mass
Authors: Michelle M A Kip; Martijn L J Oonk; Mark-David Levin; Annemarie Schop; Patrick J E Bindels; Ron Kusters; Hendrik Koffijberg Journal: BMC Med Inform Decis Mak Date: 2020-07-31 Impact factor: 2.796