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Almost one in four cancers detected in men were overdiagnosed in 2012, according to our new research, published today in the Medical Journal of Australia. In the same year, we found that approximately one in five cancers in women were overdiagnosed. Overdiagnosis is when a person is diagnosed with a "harmless" cancer that either never grows or grows very slowly. These cancers are sometimes called low or ultra-low-risk cancers and wouldn't have spread or caused any problems even if left untreated. Cancer overdiagnosis can result in people having unnecessary treatments, such as surgery, radiotherapy and hormone therapy. Being diagnosed with cancer and having cancer treatments can cause physical, psychological and financial harms.

Last week, the American Cancer Society published new guidelines that call for colorectal cancer screening to begin at age 45 - five years earlier than the group had previously recommended. But some experts are saying not so fast. The new recommendation was made in reaction to increasing rates of colorectal cancer among people younger than 50. But while the rise in cancers among this younger age group is troubling, this new recommendation was made before we know what's behind the new trend. And it's not clear that screening can help.It makes intuitive sense to respond to increasing rates of colon cancer among young people by lowering the screening age, said Michael Hochman, director of the the Gehr Family Center for Health Systems Science at the Keck School of Medicine in Los Angeles. "But if I had a quarter for every time in medicine that we were tricked by an idea with intuitive appeal, I'd be a rich man," Hochman said.

In this case, because pancreatic cancer is relatively rare, the impressive-sounding 50% reduction doesn't amount to very much. According to the American Cancer Society, a 60-year-old man has a 0.41% (1 in 241) chance of developing pancreatic cancer during the next ten years. (Risk varies greatly with age and is much lower at younger ages.) So cutting that risk in half might bring it down to about 0.2% (1 in 480). It's a 50% drop, sure, but the risk was already very small to begin with. In this case, it's more helpful to news and health care consumers to describe it as a 0.2 percentage point reduction. And then there are the harms of regular aspirin use; the Yale news release that the tweet links to doesn't mention any. But taking aspirin regularly isn't a harmless intervention - far from it. It's well known that taking aspirin every day can cause serious bleeding in the gastrointestinal system and, less frequently, in the brain. That's why guidelines for aspirin use in cardiovascular disease prevention don't recommend it for people at low risk of a heart attack. The potential benefits may be outweighed by the risks of a serious bleed.

An opinion piece in last week's Annals of Internal Medicine argues that just how aggressively we screen for some cancers can actually distort our understanding of the risk factors for a particular cancer, as well as how common we perceive it to be.

The more serious problem with California's law is one of effect size. Health, and cancer, aren't binary. Consumers can't just be concerned with whether a danger exists; they also need to be concerned about the magnitude of that risk. Even if there's a statistically significant risk between huge quantities of coffee and some cancer (and that's not proven), it's very, very small. Cigarettes have a clear and easily measured negative impact on people's health. Acrylamide, especially the acrylamide in coffee, isn't even close. Warning labels should be applied when a danger is clear, a danger is large and a danger is avoidable. It's not clear that, with respect to acrylamide, any of these criteria are met. It's certainly not the case regarding coffee. Whatever the intentions of Proposition 65, this latest development could do more harm than good.

"we pushed back against a misleading news release from Yale University that ran with the headline, "Yale researchers discover underlying cause of myeloma." The release claimed that the researchers identified "what causes a third of all myelomas," describing a faulty immune system response to compounds known as lysolipids as the culprit. But that characterization was wrong. First off, the research only demonstrated an association between lysolipids and this cancer - they didn't prove that one caused the other. And far from applying to a third of myeloma patients, the findings applied only to a tiny group of patients "

ASCO's news release about the screening study laments the "unfortunate" low rate of lung cancer screening and calls for an awareness campaign to encourage more smokers to get screened. Missing is discussion of legitimate reasons smokers might have to decline screening including substantial harms and a modest benefit. Following ASCO's lead, Bloomberg and HealthDay both echoed dramatic language about the finding without providing any perspective from independent experts who might voice reservations about screening.

Interesting discussion of why headlines like this one "85% accurate" for the detection of stomach cancer" about an experimental breath test are problematic (because some people who don't have the condition get diagnosed with it, and they can miss people who genuinely do have the condition!). Good example using pregnancy tests as an infographic.