A screening test incidentaloma can make healthy people ill

An “incidentaloma” is a finding on a diagnostic test that’s found, well, incidentally while looking for something else.

In many cases, these findings are benign but may necessitate more invasive tests to prove so.

Writing in the New York Times, cardiologist Peter Libby notes the problems of the incidentaloma.

When a patient undergoes a screening exam — a CT scan for lung cancer, for instance — findings on the study may require further tests. More imaging studies, for example.  Or worse, a biopsy.

These tests can expose patients to complications that can “make an otherwise healthy person ill.”

Dr. Libby rightly notes that,

it’s important to think rigorously about the benefits versus the risks and costs of medical procedures, rather than relying on impressions or remarkable individual cases. The medical literature indicates that incidental findings leading to follow-up medical procedures occur in more than 8 percent of cardiovascular imaging studies.

When you consider the number of imaging studies performed daily, 8 percent is a lot. And when it comes to the heart, further tests like a cardiac catheterization, are often the next step.

The consequences of these “false positives” are often under-publicized and don’t resonate with patients. Although it’s encouraging that recent stories in the Times and Associated Press have provided a balanced take on screening tests, they often don’t have the emotional impact that, say, an inspirational, life saving story from early cancer detection has.

The best that we can do is continue to publicize balanced takes on the issue, and better inform patients of the real risks of promiscuous screening.

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