Footnotes

• Twitter @ebmgatineau, @RolandGrad

• Contributors Clinical practice guidelines support primary care providers in delivering preventive health services and diagnosing disease. For providers to have meaningful discussions with their patients, basic information is needed on the potential benefits and harms of receiving a diagnosis, including the harm of overdiagnosis. While developing guidelines on screening interventions, we realised that the concept of overdiagnosis was harder to grasp outside of the context of cancer screening. For example, overdiagnosis is harder to conceptualise in the context of screening to prevent fragility fracture, as this process yields a risk of future fracture. Similarly, screening for cervical or colon cancer mainly results in detection of precancerous lesions which has implications on incidence of diseases. This article discusses these challenges in the understanding of overdiagnosis.

• Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

• Competing interests None declared.

• Provenance and peer review Not commissioned; internally peer reviewed.