{"entity":{"id":"idea-prev-annual-overdiagnosis-reporting","kind":"idea","name":"Every screening programme must publish its overdiagnosis rate each year","aka":[],"tldr":"Screening finds cancers that would never have caused harm, but programmes only report cancers found. Publishing the estimated overdiagnosis rate alongside would make the trade-off visible.","summary":"Overdiagnosis is estimable from excess cumulative incidence versus unscreened comparators and from modelling. Propose a regulatory requirement for annual reporting of estimated overdiagnosis, false positives, and procedures per cancer, in standard formats, for every publicly funded screening programme and any reimbursed MCED.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Overdiagnosis and false alarms): Welch & Black, Overdiagnosis in cancer (JNCI 2010)","url":"https://doi.org/10.1093/jnci/djq099"}],"tags":[],"related":[],"cancers":[],"sections":["early-detection"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["ppv"],"trials":[],"people":[],"bottlenecks":["b-overdiagnosis","b-incentive-misalignment"],"keyPapers":["paper-welch-j-natl-cancer-inst"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Mandatory reporting drives programme changes (thresholds, intervals) that reduce overdiagnosis by at least 20% within five years without reducing advanced-cancer detection.","rationale":"Current metrics reward detection volume; what is measured is managed.","test":"Adopt in one country; compare programme changes with non-adopters.","maturity":"speculative","actor":"regulator","cost":"small","horizonYears":3},"route":"/ideas/idea-prev-annual-overdiagnosis-reporting/","neighbours":{"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"term":[{"id":"ppv","kind":"term","name":"Positive predictive value (PPV)","route":"/terms/ppv/"}],"bottleneck":[{"id":"b-incentive-misalignment","kind":"bottleneck","name":"Incentives reward me-too drugs and marginal gains","route":"/bottlenecks/b-incentive-misalignment/"},{"id":"b-overdiagnosis","kind":"bottleneck","name":"Overdiagnosis and false alarms","route":"/bottlenecks/b-overdiagnosis/"}],"paper":[{"id":"paper-welch-j-natl-cancer-inst","kind":"paper","name":"Overdiagnosis in cancer","route":"/key-papers/paper-welch-j-natl-cancer-inst/"}]}}