Overdiagnosis is now recognized as a common and serious problem in human medicine that causes substantial harm in terms of unnecessary costs, wasted resources, and patient and caregiving suffering. International conferences (e.g. Preventing Overdiagnosis) and special features in major medical journals (e.g. Too Much Medicine in the British Medical Journal and Less is More in the AMA journal) have been dedicated to discussions of overdiagnosis and overtreatment. In 2012, a consortium of 70 specialty groups created the online resource Choosing Wisely to help physicians and patients make evidence-based decisions that reduce overdiagnosis and overtreatment. Even an influential popular book has been written on the subject: Overdiagnosed: Making people sick in the pursuit of health.
Changes in clinical practice guidelines and public education strategies have resulted from the growing recognition of the risk of overdiagnosis in human medicine, including highly publicized changes in recommendations for prostate cancer screening in men and breast cancer screening in women.
However, there seems to be little discussion in the veterinary literature or veterinary curriculum of the problem of overdiagnosis and the risks it poses to veterinary patients. In the past, IK have discussed the evidence regarding potential sources of overdiagnosis in veterinary medicine, such as pre-anesthetic blood testing (also c.f. 1, 2). However, among veterinarians and animal owners, there seems to be a near total lack of awareness of the fact that sometimes testing for and diagnosing a condition can actually lead to a worse outcome for the patient than not diagnosing it.
This is a counterintuitive idea, but it is well-established in human medicine. Changes in guidelines for prostate cancer screening, breast cancer screening, thyroid cancer testing, and many other conditions have come about because of the recognition that inappropriately targeted diagnostic tests can harm patients and waste resources on treatments that do not make people better. It is time we took a serious look at this issue in veterinary medicine, and made an effort to collect the data needed to understand its scope and causes so that we can better serve our patients. Since I was unable to find virtually any discussion of the subject in the veterinary literature, I have written a commentary raising the subject, which I hope will stimulate needed discussions on this topic.
McKenzie, BA. Overdiagnosis. Journal of the American Veterinary Medical Association. 2016:249(8);884-889.