For most of my life, I was a naive believer in “more preventive diagnosis is better”. It seemed to make sense. But the reverse is true, and for just about everyone. That’s because numerous harms come from looking harder and harder for potential issues in otherwise healthy people.
Sometimes (rarely) the harm is only financial: I myself suffered from overdiagnosis when a brain scan some years ago delivered an incidental finding of a bulge in a major cranial artery, characterized as one that causes instant death for the 1% to 2% of people in which it ruptures. It ended up costing me $20,000 in tripled life insurance premiums over the next decade. Huge cost, negative benefit—nothing could be done about it. It worried me a little at first, but I decided to ignore it and so other harms were avoided (emotional, physical). Ten years later, that bulge had disappeared, as a follow-up scan proved. Which is the case for all sorts of incidental medical findings, including many cancers—apparent issues never become real issues, or just go away entirely.
Every one of us probably has half a dozen incidental latent issues that could raise concerns, leading to a lifetime of worrying, treatment with side effects, surgeries, etc. With few exceptions, the result is harm for many, and benefits for very few.
- The harder you look for things, the more you’ll find. Many of the “epidemics” are epidemics of overdiagnosis, with no change in the baseline deaths from the issue.
- Early diagnosis often has no impact whatsoever on the ultimate outcome, as double-blind studies prove. A life is not saved or improved; rather emotional, physical and financial harms all accrue.
- Life-changing harms can result from overdiagnosis: emotional, physical (drugs, surgery). Yet excepting a very few conditions, it is usually the case that more harm is done than good, as studies prove.
- With all sorts of medical issues, many go away on their own or regress, or just never develop into problems, or will never be an issue.
- Highly misleading medical marketing relies on anecdotes and misleading statistics to walk right up to the line on lying about the issues.