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Comment & Response
May 2018

Uncoupling Diagnosis and Treatment of Incidentally Imaged Renal Masses

Author Affiliations
  • 1Division of Surgery and Interventional Science, University College London, London, England
  • 2Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, England
JAMA Intern Med. 2018;178(5):728. doi:10.1001/jamainternmed.2018.1186

To the Editor We would like to commend Welch et al for their recently published population-based analysis1 that clearly illustrates that the more we image, the more we treat and, the more potential harm we cause. As Welch et al note, previous work has shown that the diagnostic rate of incidental small renal masses has increased since the 1970s and that this has been fuelled by uptake of imaging methods, but earlier diagnosis has had no impact in kidney cancer mortality. Welch et al1 go 1 step further by providing, for the first-time to our knowledge, evidence that overdiagnosis of kidney masses does indeed lead to overtreatment.

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