The impact of a misinterpretation of the term “overtreatment”

Abstract

The impact of a misinterpretation of the term "overtreatment" Dear Editor, Collective screening identifying endocrine diseases has not only the advantage of achieving early diagnosis but also the disadvantage of leading to overdiagnosis. Overdiagnosis involves the identification of diseases that would not have been diagnosed throughout the life course without screening. Therefore, diagnosis and treatment would actually be unnecessary for overdiagnosed patients throughout their life, and would also confer major disadvantages for them, not only physically but also psychosocially. When overdiagnosis of cancer occurs, the pathological diagnosis itself is correct, so overdiagnosis is completely different from misdiagnosis. Treatment in cases of overdiagnosis can be defined as overtreatment [1]. Clinicians may underestimate the disadvantages of overdiagnosis and overtreatment because it is not known in individual cases whether the diagnosis involves overdiagnosis or early detection that would benefit the patient [2]. There is also confusion in the use of the terms "overdiagnosis" and "overtreatment," which obscures the harm inflicted when these occur. As a representative case of this, we would like to point out a couple of seriously misleading descriptions in the discussion of the article by Sakamoto et al. [3]. First, there is a misinterpretation of the term "overtreatment". Sakamoto et al. [3] concluded that "problems concerning overtreatment basically do not occur in this survey" based on the cited paper, not on their analyzed data. They used the term "overtreatment" here simply to mean not performing excessive surgical treatment. However, the NCI Dictionary of Cancer Terms defines "overtreatment" as follows: "Treatment of a cancer that would have gone away on its own or never caused any symptoms. These cancers are usually found on a screening test. Overtreatment may lead to problems and harmful