Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Lead-time models should not be used to estimate overdiagnosis in cancer screening

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Charlson Comorbidity Index Score and Risk of Severe Outcome and Death in Danish COVID-19 Patients

    Research output: Contribution to journalEditorialResearchpeer-review

  2. Assessment of Residents Readiness to Perform Lumbar Puncture: A Validation Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Low use and adherence to maintenance medication in chronic obstructive pulmonary disease in the general population

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Gastrointestinal events with clopidogrel: a nationwide population-based cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. No evidence for the effectiveness of IV ketamine for treatment resistant mood disorders in retrospective study

    Research output: Contribution to journalComment/debateResearchpeer-review

  2. Policy makers must act on incomplete evidence in responding to COVID-19

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Suspicions of possible vaccine harms must be scrutinised openly and independently to ensure confidence

    Research output: Contribution to journalLetterResearchpeer-review

View graph of relations

Lead-time can mean two different things: Clinical lead-time is the lead-time for clinically relevant tumors; that is, those that are not overdiagnosed. Model-based lead-time is a theoretical construct where the time when the tumor would have caused symptoms is not limited by the person's death. It is the average time at which the diagnosis is brought forward for both clinically relevant and overdiagnosed cancers. When screening for breast cancer, clinical lead-time is about 1 year, while model-based lead-time varies from 2 to 7 years. There are two different methods to calculate overdiagnosis in cancer screening--the excess-incidence approach and the lead-time approach--that rely on two different lead-time definitions. Overdiagnosis when screening with mammography has varied from 0 to 75 %. We have explained that these differences are mainly caused by using different definitions and methods and not by variations in data. High levels of overdiagnosis of cancer have usually been explained by detection of many slow-growing tumors with long lead-times. This theory can be tested by studying if slow-growing tumors accumulate in the absence of screening, which they don't. Thus, it is likely that the natural history of many subclinical cancers is spontaneous regression.

Original languageEnglish
JournalJournal of General Internal Medicine
Volume29
Issue number9
Pages (from-to)1283-6
Number of pages4
ISSN0884-8734
DOIs
Publication statusPublished - Sep 2014

ID: 44633547