We asked our SCPN team and friends what they thought was the most interesting paper that had come across their desks this year. First off Professor Bob Steele CBE Chair of the Scottish Cancer Foundation and co-director of the Scottish Cancer Prevention Network tells us about his paper of the year…. and discusses how precision medicine and big data have the potential to improve patient outcomes. But could they also increase overdiagnosis?

How precision medicine and screening with big data could increase overdiagnosis

Henrik Vogt, Sara Green, Claus Thorn Ekstrøm, John Brodersen

The BMJ

https://doi.org/10.1136/bmj.l5270

Why this paper?

“How precision medicine and screening with big data could increase overdiagnosis”, an analysis paper in the BMJ by Vogt, Green, Ekstrøm and Brodersen is my paper of the year for a number of reasons. First, it emphasises the harm caused by overdiagnosis, something we struggle with in all health screening. Then, they point out how the use of big data and precision medicine, particularly genomic risk scores can provide information that we do not know how to handle and will certainly lead to diagnoses that cannot be acted upon. The authors do not, however, discount the value of progress in these areas. Their message is that “the creation of beneficial precision medicine will require patience, tolerance and wisdom”, and they stress the need to adhere to the traditional screening principles as articulated by Wilson and Jungner for the World Health Organisation.