Why Some Doctors Say There Are Cancers That Shouldn’t Be Treated (Gina Kolata, Dec. 8, 2025, NY Times)
The idea that finding a cancer early is not always a good thing is not easy for many patients and their families to accept. And it is true that lives can be saved by treating cancer early.
Autopsy studies repeatedly find that many people die with small cancers they were unaware of. A review of these studies in prostate cancer reported that the cancer can appear in men as young as their 20s. The older the men were, the more likely they were to have undetected prostate cancer. By their 70s, about a third of white men and half of Black men had undetected prostate cancer.
A study of thyroid cancer in Finland found that at least a third of adults had undetected tumors. Less than one percent of people die from thyroid cancer
The problem is that it is impossible to know if someone’s cancer will be deadly or not. And if the cancer is gone after treatment, there is no way to know if it needed to be treated.
But there’s a way to know on a population level if an increase in diagnoses is a false alarm or a danger signal, said Dr. H. Gilbert Welch of Brigham and Women’s Hospital of Harvard Medical School. Look at the number of deaths from that cancer. If more lethal cancers are being found, there should be more deaths. But if the death rate remains steady as the incidence of that cancer spikes, many of those patients did not need to receive diagnoses.
That happened, for example, with thyroid cancer in South Korea. The incidence of thyroid cancer soared with the introduction of widespread ultrasound screening. But deaths did not increase. It was estimated that 90 percent of the cancers that were discovered and treated in women did not need to be found.
Well aware of such incidents, Dr. Vishal R. Patel of Harvard, Dr. Welch and Dr. Adewole S. Adamson of Dell Medical School in Austin, Texas, asked whether the current spike in diagnoses in younger people of those eight cancers is tied to more deaths.
It is not, they reported in a recent paper examining trends over the past three decades.
For all but two of the eight cancers whose incidence has soared in younger people, death rates are flat or declining.