Overdiagnosis of gastric cancer by endoscopic screening

Figure 4 A value framework for cancer screening. The value of cancer screening strategies is linked to the screening intensity (population screened, frequency, and sensitivity of the test used) and is determined by the balance among benefits (e.g., cancer mortality reduction), harms (e.g., anxiety from false-positive test results, harms of diagnostic procedures, labeling, and overdiagnosis leading to overtreatment), and costs. The value of cancer screening is determined by a trade-off between benefits vs harms and costs. As the intensity increases, the benefits of screening rapidly increase. However, as the intensity increases beyond an optimal level, the increase in benefits slows down whereas harms and costs increase rapidly, and the value decreases[14].