<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2529-850X</journal-id>
<journal-title><![CDATA[Journal of Negative and No Positive Results]]></journal-title>
<abbrev-journal-title><![CDATA[JONNPR]]></abbrev-journal-title>
<issn>2529-850X</issn>
<publisher>
<publisher-name><![CDATA[Research and Science S.L.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2529-850X2020000400002</article-id>
<article-id pub-id-type="doi">10.19230/jonnpr.3299</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Beneficios y "maleficios" del cribado. El sobrediagnóstico y la medicina anticipativa]]></article-title>
<article-title xml:lang="en"><![CDATA[Benefits and damages of Screening. Overdiagnosis and anticipatory medicine]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zarazaga]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Franco-López]]></surname>
<given-names><![CDATA[Ángeles]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="Ab "/>
<xref ref-type="aff" rid="Af2"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Culebras]]></surname>
<given-names><![CDATA[Jesús M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="Ab "/>
<xref ref-type="aff" rid="Af3"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Autónoma de Madrid Departamento de Cirugía ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital de Vinalopó Servicio de Radiología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="A2b">
<institution><![CDATA[,Hospital de Torrevieja Servicio de Radiología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="A2c">
<institution><![CDATA[,Agencia Nacional de Evaluación de la Calidad y Acreditación  ]]></institution>
<addr-line><![CDATA[Alicante ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Real Academia de Medicina de Valladolid  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="A3b">
<institution><![CDATA[,Universidad de León Instituto de Biomedicina ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="A3c">
<institution><![CDATA[,Instituto de España Academia Española de Nutrición y Dietética ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="A3d">
<institution><![CDATA[,Journal of Negative &amp; No Positive Results  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<volume>5</volume>
<numero>4</numero>
<fpage>369</fpage>
<lpage>378</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S2529-850X2020000400002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S2529-850X2020000400002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S2529-850X2020000400002&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Mucho han cambiado los resultados en el tratamiento del cáncer de mama desde la publicación de trabajos que recomendaban la realización de cribados para diagnosticar precozmente los tumores de mama. Los posteriores re-análisis, que mostraron errores en las evaluaciones, los avances en la terapia oncológica y la concienciación de profesionales y público, han demostrado la dudosa efectividad de esta medida y como contrapartida los riesgos dependientes por sobrediagnóstico y sobretratamiento. Por otra parte la falta de información e incluso la desinformación existente sobre el tema, han ocasionado una desorientación entre los posibles beneficiarios del procedimiento. Se les ha recomendado, por parte de organizaciones, plataformas, sociedades privadas y servicios de salud pública, un procedimiento ocultando daños importantes: físicos, psicológicos y económicos. Es fácil promover el examen de mamografía si la mayoría de las mujeres cree que previene o reduce el riesgo de contraer cáncer de seno y salva muchas vidas mediante la detección temprana de tumores agresivos. Desgraciadamente eso no es así. A la vista de ello, existen muchos detractores del cribado que vienen recomendando la información fiable y correcta y la indicación personal no tanto del cribado como de la exploración como procedimiento diagnóstico. Las mujeres deben discutir con sus médicos su propio perfil de riesgo, los posibles beneficios, daños y complejidades de la mamografía de detección, y tomar decisiones informadas sobre la realización del cribado. Definir qué mujeres se beneficiarían de un seguimiento debido a factores de riesgo definidos y aquellas que por el contrario corren más riesgos que beneficios. Un programa de salud pública que claramente no produce más beneficios que daños es difícil de justificar. Proporcionar información clara e imparcial, promover la atención adecuada y prevenir el sobrediagnóstico y el sobretratamiento sería la mejor opción.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Treatment of breast cancer has changed markedly since the publication of papers recommending screening programs for early diagnosis. Posterior reevaluations demonstrated mistakes; advances in oncological therapy and better knowledge of the problem have demonstrated the doubtful efficacy of these procedures which, on the other hand have also side effects with risk of overdiagnosis and overtreatment. Misinformation confuses patients. This procedure has been recommended by many institutions without explaining possible important risks. It is very easy to promote mammograms if the majority feel that it reduces risk of breast cancer and saves many lives. Unfortunately this is not the case. At present there are many people against screening who are recommending explicit and precise explanations of the procedure as well as of the importance of physical examination. Women must discuss with their physicians their own risk, possible benefits and eventual risks and damages of mammograms and they must take informed decision about screening. Women should be classified in those with potential benefits of mammograms and those with more risks than benefits. A program which does not offer clearly more benefits than risks cannot be implemented by Public Heath institutions. Complete and impartial information, adequate attention and prevention of overdiagnosis and overtreatment would be the best option.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cribado]]></kwd>
<kwd lng="es"><![CDATA[Sobrediagnóstico]]></kwd>
<kwd lng="es"><![CDATA[Medicina anticipativa]]></kwd>
<kwd lng="en"><![CDATA[Screening]]></kwd>
<kwd lng="en"><![CDATA[Overdiagnosis]]></kwd>
<kwd lng="en"><![CDATA[Anticipatory medicine]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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