Overdiagnosis: Is more always better?

Adamson AS Naik G Jones MA , et al. (2024) Ecological study estimating melanoma overdiagnosis in the USA using the lifetime risk method. BMJ Evidence-Based Medicine 29(3): 156–161. DOI: 10.1136/bmjebm-2023-112460.

Baker M Jeffers H (2016) Continuity of Care in Modern Day General Practice. London: Royal College of General Practitioners. Available at: www.rcgp.org.uk/getmedia/11f26527-5d11-47f2-a593-1a894c2fff1b/Continuity-of-care-in-modern-day-general-practice1.pdf (accessed 3 February 2026).

Bell K Doust J Sanders S , et al. (2022) A novel methodological framework was described for detecting and quantifying overdiagnosis. Journal of Clinical Epidemiology 148: 146–159. DOI: 10.1016/j.jclinepi.2022.04.022.

Berland LL Silverman SG Gore RM , et al. (2010) Managing incidental findings on abdominal CT: white paper of the ACR Incidental Findings Committee. Journal of the American College of Radiology 7(10): 754–773. DOI: 10.1016/j.jacr.2010.06.013.

Bodfield KS Culshaw A (2023) The place for diagnosis in the UK education system? Emotional and Behavioural Difficulties 28(4): 316–328. DOI: 10.1080/13632752.2024.2316398.

Bohr A Memarzadeh K (2020) The rise of artificial intelligence in healthcare applications. In: Bohr A Memarzadeh K (eds) Artificial Intelligence in Healthcare. Academic Press, pp. 25–60. DOI: 10.1016/B978-0-12-818438-7.00002-2.

Brodersen J Schwartz LM Heneghan C , et al. (2018) Overdiagnosis: what it is and what it isn’t. BMJ Evidence-Based Medicine 23(1): 1–3. DOI: 10.1136/ebmed-2017-110886.

Capurro D Coghlan S Pires DEV (2022) Preventing digital overdiagnosis. JAMA 327(6): 525. DOI: 10.1001/jama.2021.22969.

Chiolero A Paccaud F Aujesky D , et al. (2015) How to prevent overdiagnosis. Swiss Medical Weekly 145: w14060. DOI: 10.4414/smw.2015.14060.

Davies E (2024) Informed by research, transformed by research. BMJ Evidence-Based Medicine 29(1): 62–63. DOI: 10.1136/bmjebm-2023-112646.

Diamandis EP Li M (2016) The side effects of translational omics: overtesting, overdiagnosis, overtreatment. Clinical Chemistry and Laboratory Medicine (CCLM) 54(3): 389–396. DOI: 10.1515/cclm-2015-0762.

Divo MJ Martinez CH Mannino DM (2014) Ageing and the epidemiology of multimorbidity. European Respiratory Journal 44(4): 1055–1068. DOI: 10.1183/09031936.00059814.

Doles N Ye Mon M Shaikh A , et al. (2025) Interpretating normal values and reference ranges for laboratory tests. The Journal of the American Board of Family Medicine 38(1): 174–179. DOI: 10.3122/jabfm.2024.240224r1.

Duffy SW Vulkan D Cuckle H , et al. (2020) Effect of mammographic screening from age 40 years on breast cancer mortality (UK Age trial): final results of a randomised, controlled trial. The Lancet Oncology 21(9): 1165–1172. DOI: 10.1016/s1470-2045(20)30398-3.

Dunn BK Woloshin S Xie H , et al. (2022) Cancer overdiagnosis: a challenge in the era of screening. Journal of the Naional Cancer Center 2(4): 235–242. DOI: 10.1016/j.jncc.2022.08.005.

Forbes LJ Marchand C Doran T , et al. (2017) The role of the Quality and Outcomes Framework in the care of long-term conditions: a systematic review. British Journal of General Practice 67(664): e775–e784. DOI: 10.3399/bjgp17x693077.

Gupta P Gupta M Koul N (2020) Overdiagnosis and overtreatment; how to deal with too much medicine. Journal of Family Medicine and Primary Care 9(8): 3815–3819. DOI: 10.4103/jfmpc.jfmpc_433_20.

Hofmann B Reid L Carter S , et al. (2021) Overdiagnosis: one concept, three perspectives, and a model. European Journal of Epidemiology 36(4): 361–366. DOI: 10.1007/s10654-020-00706-4.

Johansson M Hansson A Brodersen J (2015) Estimating overdiagnosis in screening for abdominal aortic aneurysm: could a change in smoking habits and lowered aortic diameter tip the balance of screening towards harm? BMJ 350: h825. DOI: 10.1136/bmj.h825.

Jutel A (2009) Sociology of diagnosis: a preliminary review. Sociology of Health & Illness 31(2): 278–299. DOI: 10.1111/j.1467-9566.2008.01152.x.

Kale MS Korenstein D (2018) Overdiagnosis in primary care: framing the problem and finding solutions. BMJ 362: k2820. DOI: 10.1136/bmj.k2820.

Li M Maso LD Vaccarella S (2020) Global trends in thyroid cancer incidence and the impact of overdiagnosis. The Lancet Diabetes & Endocrinology 8(6): 468–470. DOI: 10.1016/s2213-8587(20)30115-7.

Lyu H Xu T Brotman D , et al. (2017) Overtreatment in the United States. PLOS ONE 12(9): e0181970. DOI: 10.1371/journal.pone.0181970.

McCaffery K Nickel B Pickles K , et al. (2019) Resisting recommended treatment for prostate cancer: a qualitative analysis of the lived experience of possible overdiagnosis. BMJ Open 9(5): e026960. DOI: 10.1136/bmjopen-2018-026960.

McCartney M McCutcheon C Cooke M , et al. (2023) Investigation into financial conflicts of interest and screening for atrial fibrillation in the UK: a cross-sectional study. BMJ Evidence-Based Medicine 28(1): 15–20. DOI: 10.1136/bmjebm-2022-112004.

Moynihan R Doust J Henry D (2012) Preventing overdiagnosis: how to stop harming the healthy. BMJ 344: e3502. DOI: 10.1136/bmj.e3502.

Nguyen M-LT Honcharov V Ballard D , et al. (2024) Primary care physicians’ experiences with and adaptations to time constraints. JAMA Network Open 7(4): e248827. DOI: 10.1001/jamanetworkopen.2024.8827.

NICE (2022) NICE Health Technology Evaluations: The Manual. Available at: www.nice.org.uk/process/pmg36/chapter/introduction-to-health-technology-evaluation (accessed 8 September 2025).

NICE (2023) Cardiovascular disease: risk assessment and reduction, including lipid modification. Available at: www.nice.org.uk/guidance/ng238/chapter/rationale-and-impact (accessed 8 September 2025).

Pathirana T Clark J Moynihan R (2017) Mapping the drivers of overdiagnosis to potential solutions. BMJ. DOI: 10.1136/bmj.j3879.

Pilvar H Watt T (2025) The effect of workload on primary care doctors on referral rates and prescription patterns: evidence from English NHS. The European Journal of Health Economics 26(5): 817–837. DOI: 10.1007/s10198-024-01742-7.

Slawomirski L Kelly D de Bienassis K , et al. (2025) The economics of diagnostic safety. OECD Health Working Papers. DOI: 10.1787/fc61057a-en.

UK National Screening Committee (2019) Breast Cancer. GOV.UK. Available at: https://view-health-screening-recommendations.service.gov.uk/breast-cancer (accessed 8 September 2025).

UK National Screening Committee (2020) Prostate Cancer. GOV.UK. Available at: https://view-health-screening-recommendations.service.gov.uk/prostate-cancer (accessed 8 September 2025).

Walker MJ Rogers W (2017) Defining disease in the context of overdiagnosis. Medicine, Health Care and Philosophy 20(2): 269–280. DOI: 10.1007/s11019-016-9748-8.

Wallis S Donnelly PD Sullivan F , et al. (2025) From early diagnosis to optimal diagnosis: a conference report on what excellent innovation should look like. BMJ Innovations 11(3): 161–164. DOI: 10.1136/bmjinnov-2024-001304.

Welch HG Kramer BS Black WC (2019) Epidemiologic signatures in cancer. New England Journal of Medicine 381(14): 1378–1386. DOI: 10.1056/nejmsr1905447.

Wiener RS Schwartz LM Woloshin S (2013) When a test is too good: how CT pulmonary angiograms find pulmonary emboli that do not need to be found. BMJ 347: f3368. DOI: 10.1136/bmj.f3368.