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Invited Commentary |

Pseudodisease, the Next Great Epidemic in Coronary Atherosclerosis?  Comment on “Impact of Coronary Computed Tomographic Angiography Results on Patient and Physician Behavior in a Low-Risk Population”

Michael S. Lauer, MD
Arch Intern Med. 2011;171(14):1268-1269. doi:10.1001/archinternmed.2011.205.
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Between 1995 and 2000, public health authorities in 6 of 16 German states offered urine screening for neuroblastoma to the parents of more than 2.5 million 1-year-old infants.1 Nearly 1.5 million infants underwent screening, leading to a diagnosis of neuroblastoma in 149. Physicians diagnosed neuroblastoma twice as often in the 6 screening states as in the 10 nonscreening states, yet the rates of stage 4 neuroblastoma diagnoses were virtually identical, as were death rates from neuroblastoma, in states that screened as those that did not. As reported by Schilling et al,1 screening succeeded in increasing diagnosis of early disease, yet had no impact on reducing rates of advanced or fatal disease. Investigators in Japan and Canada reported similar findings: screening led to more diagnoses and more interventions but failed to prevent advanced disease or deaths.1,2

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