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Overdiagnosis As An Extreme Form of Length-Time Bias: Breast Cancer Screening As Example
Overdiagnosis As An Extreme Form of Length-Time Bias: Breast Cancer Screening As Example
length-time bias
Reference:
Failure of Researchers, Reviewers, Editors, and the Media to Understand Flaws in Cancer Screening
Studies.Berry DA. Cancer. 2014;(Article first published online: 12 JUN 2014):1–8. doi: 10.1002/cncr.28795.
A B S C D
A = Tumor onset
B = Beginning of the period in which breast cancer can be diagnosed with
screening mammography
C = Start of the clinical phase (signs-symptoms) of breast cancer
D = Death because breast cancer, o for any cause
BC = Length time bias when BC is longer than usual, or even close or equal to "n"
(being "n" the number of years of health expectancy at the time of diagnosis).
A B S C D
A = Tumor onset
B = Beginning of the period in which breast cancer can be diagnosed with
screening mammography
C = Start of the clinical phase (signs-symptoms) of breast cancer
D = Death because breast cancer, o for any cause
BC = Length time bias when BC is longer than usual, or even close or equal to "n"
(being "n" the number of years of health expectancy at the time of diagnosis).
References:
•Bewildering genetic intratumor heterogeneity: Evolution through space and time. Available in:
http://cancerres.aacrjournals.org/content/72/19/4875.short
•Cancer intra-heterogeneity. Can the degree of genetic chaos accurately predict of tumour recurrence? Probably. Available in:
http://scienceblog.cancerresearchuk.org/2014/10/09/lung-cancer-evolution-a-journey-through-space-and-time/
•Overdiagnosis. Tracking the clonal origin of lethal prostate cancer. Available in: http://www.jci.org/articles/view/70354
CONCLUSIONS (II)
We don’t know why overdiagnosis is so common and, worse, we
cannot separate tumors that are overdiagnosis (we cannot at the
time of diagnosis identify "overdiagnosis tumors").
References:
•Macroscopic stiffness of breast tumors predicts metastasis. Available in: http://www.nature.com/srep/2014/140701/srep05512/pdf/srep05512.pdf