The massive effort to reduce the death toll from cancer has made stunning progress. Though it is still the second leading cause of death in the United States, since 1990, the mortality rate is down roughly one-third. More than half of all cancers can now be treated as chronic conditions, or cured outright. A diagnosis of cancer is no longer a death sentence.

But a majority of the public still believes that cancer always means death. That disconnect, between what was much closer to the truth decades ago and what is true now, leads to enormous harm all by itself. Encouragingly, however, work to reduce that harm is now joining the fight against the disease itself, in a many-faceted effort that is also beginning to save lives and reduce harm.

Much of this work is coming from what might be called "The Overdiagnosis Movement." Doctors and researchers have begun to realize the harm that can be caused by “the labeling of a person with a disease or an abnormal condition that would not have caused the person harm if left undiscovered.” This is overdiagnosis, a health threat only recently formally recognized in medicine, that often sets off medical cascades of testing and treatment that are sometimes harmful, even fatal.

A major focus of this work has been on overdiagnosed cancer. More perceptive cancer screening technologies now quite often detect types of the disease—ductal carcinoma in situ (DCIS) breast cancer, many cases of prostate cancer, the vast majority of thyroid cancers, and even some lung cancers—that look like cancer under a microscope but that are so slow or nongrowing that they are highly unlikely to ever cause any harm. When patients diagnosed with these cancers hear the dreaded words “You have cancer,” despite reassurance from their physician that their disease poses practically no threat, the now-outdated fear that all........

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