Screening and Surveillance Bias in Cancer

Tancredi, Stefano; Cullati, Stéphane

doi:10.3390/epidemiologia4020012

Cited by 4 publications

(2 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This was also observed in our cohort, where patients with GD underwent more screening tests for cancer compared to controls. A higher frequency of screening tests can lead to a higher probability of detecting cancers, and this higher probability can be misinterpreted as a higher disease risk [13]. Undergoing more skin screen tests probably increased the likelihood of being diagnosed with skin cancer, mainly NMSC [14].…”

Section: Discussionmentioning

confidence: 99%

Cancer Risk in Patients with Gaucher Disease Using Real-World Data

Revel-Vilk,

Zimran,

Istaiti

et al. 2023

JCM

View full text Add to dashboard Cite

The association between GD and cancer has been uncertain due to ascertainment bias in previously published studies. We analyzed cancer incidence using the Maccabi Healthcare Service (MHS) electronic health records among 264 patients with GD compared to 3440 matched controls. We ascertained cancers diagnosed before and after the index date (i.e., the first documentation of GD in cases and the corresponding date for controls). Before the index date, cancers were diagnosed in 18 individuals, with 11 (4.2%) in the GD group and 7 (0.2%) in the control group. After the index date, cancers were diagnosed in 57 individuals, with 20 (7.9%) in the GD group and 37 (1.1%) in the control group, with a median follow-up of almost 13 years in both groups. The most common cancers diagnosed in GD were non-melanoma skin cancer (NMSC) and hematological malignancies, with a clustering of diagnoses around the time of GD diagnosis. The incidence of cancers (excluding MNSC) was 4.1 (95% CI 2.2–7.1) and 0.7 (95% CI 0.4–0.9) per 1000 patient-years in the GD and control groups, respectively, with an incidence rate ratio of 6.37 (95% CI 3–12.7). Patients with GD underwent more cancer screening tests than their counterparts in the control group. While our study revealed an increased occurrence of cancers in patients with GD, this finding might be partly attributed to the more rigorous surveillance procedures employed in this patient population.

show abstract

Section: Discussionmentioning

confidence: 99%

Cancer Risk in Patients with Gaucher Disease Using Real-World Data

Revel-Vilk,

Zimran,

Istaiti

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…from DSM-IV to DSM-V and ICD-10 to ICD-11), 46,47 or clinical guidelines, which may alter sampling over time and bias GD prevalence estimates (see "chronology bias" or "surveillance bias"). 48,49 The authors fail to demonstrate that the observed increase is either unexpected or of concern, yet the assumption of both underpins the Cass Review and its commissioning. Regarding the co-occurrence of ASD and GD, the authors conclude that this has increased, without appropriate statistical tests (e.g., time trend analysis) 50 or consideration of changes in the visibility and diagnosis of ASD, despite also warning of large confidence intervals.…”

Section: The Primary Researchmentioning

confidence: 99%

Critically Appraising the Cass Report: Methodological Flaws and Unsupported Claims

Noone,

Southgate,

Ashman

et al. 2024

Preprint

View full text Add to dashboard Cite

The Cass Report aimed to provide recommendations for how services for gender diverse children and young people should be delivered in England. Our critical appraisal reveals significant methodological and conceptual flaws within the report and the research commissioned to inform the report, which included seven systematic reviews and both quantitative and qualitative primary research. Using the ROBIS tool, we identified a high risk of bias in each of the systematic reviews driven by unexplained protocol deviations, ambiguous eligibility criteria, inadequate study identification, and the failure to integrate consideration of these limitations into the conclusions derived from the evidence syntheses. We also identified potential sources of bias and unsubstantiated claims in the primary research that suggest a double standard in the quality of evidence produced for the Cass Report compared to quality appraisal in the systematic reviews. We discuss these issues in relation to how evidence regarding gender affirming care is framed, the wider political context, and the future for gender affirming care. To uphold evidence-based medicine, future gender-affirming care research must generate robust observational data, involve transgender communities, and prioritise patient-centred outcomes, ensuring validity, generalisability, and cultural relevance. The Cass Report’s recommendations, given its methodological flaws and misrepresentation of evidence, warrant critical scrutiny to ensure ethical and effective support for gender-diverse youth.

show abstract