Rechazar el tratamiento oncológico convencional; recurrir únicamente a la medicina alternativa (sin cirugía, quimioterapia, radioterapia ni hormonoterapia)Aceptar el tratamiento oncológico convencional (cirugía, quimioterapia, radioterapia, hormonoterapia según el estadio)
Optar por un tratamiento oncológico agresivo (sin cuidados paliativos tempranos)Integrar cuidados paliativos desde el diagnóstico (junto con la oncología)
Among 449 young breast cancer survivors, 25.2% regretted inactions
specifically — not seeking information sooner, not getting second opinions,
not being more proactive about their own care (Friedman et al. 2011). That
figure is the inaction-specific rate: 42.5% of the sample expressed any
regret, and of those, 59.2% pointed to inactions (42.5% × 59.2% = 25.2%).
Brewer et al.’s meta-analysis of 81 studies (N = 45,618) across vaccination,
screening, and other health domains confirmed the direction: anticipated
inaction regret correlated with actual health behavior at r = 0.29 and with
intentions at r = 0.52.
On the action side, a meta-analysis of 14 studies covering 17,883 localized
prostate cancer patients found that 20% reported significant decision
regret about their treatment choice, measured with the validated Decision
Regret Scale (Fanshawe et al. 2023). The regret clusters around side effects —
sexual dysfunction, urinary incontinence, bowel problems — that follow
aggressive treatment of cancers that may never have become life-threatening.
Active surveillance patients reported the lowest regret (13%), while surgery
and radiotherapy patients hovered near 18–19%. A separate 15-year follow-up
of 934 men in the population-based Prostate Cancer Outcomes Study put the
overall figure at 14.6% (Hoffman et al. 2017). This is the best-quantified
cost of early diagnosis: roughly one in five to one in seven patients wish,
in retrospect, they had chosen differently.
The gap is narrower than it first appears. Prostate cancer screening is the
single most contested domain in the overdiagnosis debate — roughly 60% of
PSA-detected cancers may be overdiagnosed — so the 20% action-regret
figure is arguably an upper bound for early diagnosis in general. The
corrected inaction-specific rate (25.2%, not the previously stated 42.5%)
comes from a sample of young women with an aggressive cancer subtype, where
the consequences of delay are stark and visible. The revised delta (-0.052)
indicates a slight tilt toward inaction regret rather than a dramatic 2:1
ratio. For genuinely indolent conditions detected only by screening, the
calculus may reverse entirely. The directional finding — that health
inaction generates more long-term regret than health action — is supported
across the literature, but the magnitude depends heavily on what you are
being screened for and how likely the disease is to matter.
Fuentes: acción
Registro de evidencia
Cada número a continuación es lo que reportó cada fuente, con la cita textual en la que nos basamos y cómo llegamos a nuestra cifra. Haz clic en cualquier enlace para verificarlo directamente.
3/3 fuentes verificadas de forma independiente palabra por palabra frente a la fuente citada
[1]European Urology Open Science — Decision Regret in Patients with Localised Prostate Cancer: A Systematic Review and Meta-analysis
Verificado
Revisado por pares
Pooled 20% (95% CI 16–23%) of patients reported significant decision regret across 14 studies
Extracto
“"Significant decision regret was present in a pooled 20% (95% confidence interval 16–23) of patients across 14 studies and 17,883 patients. Regret was lower in active surveillance (13%), with little difference between radiotherapy (19%) and prostatectomy (18%)."
”
Datos de la fuente de
2023-03-01
Accedido
2026-04-26
Verificación
Extracto recuperado de forma independiente y confirmado palabra por palabra frente a la fuente citada durante nuestra auditoría de fundamentación.
Cálculo
Fanshawe et al. 2023 meta-analysis of 14 studies using the Decision Regret Scale. The 20% pooled estimate captures regret from overdiagnosis, overtreatment, and side effects (sexual dysfunction, urinary incontinence) following early detection via PSA screening. Used as proxy for the broader cost of early diagnosis and aggressive treatment.
[2]Journal of Clinical Oncology — Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study
Verificado
Revisado por pares
14.6% expressed treatment decision regret at 15 years
Extracto
“"Overall, 14.6% expressed treatment decision regret: 8.2% of those whose disease was managed conservatively, 15.0% of those who received surgery, and 16.6% of those who underwent radiotherapy."
”
Datos de la fuente de
2017-07-12
Accedido
2026-04-26
Verificación
Extracto recuperado de forma independiente y confirmado palabra por palabra frente a la fuente citada durante nuestra auditoría de fundamentación.
Cálculo
Hoffman et al. 2017. Prostate Cancer Outcomes Study, population-based cohort of 934 men followed for 15 years. The 14.6% overall figure is lower than the meta-analytic pooled 20%, likely because the longer follow-up selects survivors who have had time to rationalize their decision.
[3]Reviews in Urology / Andriole et al. — Overdiagnosis of Prostate Cancer
Verificado
Revisado por pares
Using ERSPC (European Randomized Study of Screening for Prostate Cancer) data, Welch and Black estimated that 60% of PSA screen-detected prostate cancers were overdiagnosed
Extracto
“"Using ERSPC data, Welch and Black estimated that 60% of such screen-detected cancers were overdiagnosed."
”
Datos de la fuente de
2012-09-01
Accedido
2026-07-03
Verificación
Extracto recuperado de forma independiente y confirmado palabra por palabra frente a la fuente citada durante nuestra auditoría de fundamentación.
Cálculo
Andriole GL et al., Reviews in Urology 2012;14(3-4) (PMC3540879), reviewing Welch HG & Black WC, "Overdiagnosis in Cancer," J Natl Cancer Inst 2010;102(9):605-613. The 60% figure is the upper end of published PSA-detected prostate cancer overdiagnosis estimates (other estimates in the literature range from ~20% to 50%); cited here as context for why the 20% action-side decision-regret figure (Fanshawe et al. 2023) is plausibly an upper bound rather than an underestimate for early diagnosis in general. Not used in regret_rate arithmetic.
Fuentes: inacción
Registro de evidencia
Cada número a continuación es lo que reportó cada fuente, con la cita textual en la que nos basamos y cómo llegamos a nuestra cifra. Haz clic en cualquier enlace para verificarlo directamente.
[1]Psycho-Oncology / PMC — Post-Treatment Regret Among Young Breast Cancer Survivors
Revisado por pares
42.5% of 449 young breast cancer survivors expressed regret; of those, 59.2% regretted inactions
Extracto
“"The majority (59.2%) of participants who expressed regret did so over inactions ('I wish I had…', 'I would have…') as opposed to actions. Many women wished they had been more proactive in their care with respect to seeking information and having a better understanding of long-term effects and side effects of their treatment options."
”
Datos de la fuente de
2011-01-01
Accedido
2026-04-26
Cálculo
Friedman et al. 2011. Study of 449 young breast cancer survivors. 42.5% (191 of 449) expressed any regret. Of those who expressed regret, 59.2% regretted inactions (delayed screening, not seeking information sooner) rather than actions. Inaction-specific rate: 42.5% × 59.2% = 25.2% of the full sample regretted inactions. The prior entry incorrectly used 42.5% (total regret) as the inaction rate; the correct inaction-specific figure is 25.2%.
[2]Health Psychology — Anticipated Regret and Health Behavior: A Meta-Analysis
Revisado por pares
Anticipated inaction regret predicted health behavior (r = 0.29, p < .001) and intentions (r = 0.52) across 81 studies
Extracto
“"Greater anticipated regret from not engaging in a behavior (i.e., inaction regret) predicted stronger intentions and behavior. Anticipated inaction regret has a stronger and more stable association with health behavior than previously thought."
”
Datos de la fuente de
2016-09-01
Accedido
2026-04-26
Cálculo
Brewer et al. 2016 meta-analysis of 81 studies (N = 45,618). Demonstrates that across vaccination, screening, and other health domains, anticipated inaction regret consistently exceeds action regret. The correlation with actual health behavior is r = 0.29 (not r = 0.52, which is the correlation with intentions). The r = 0.29 figure is the relevant behavioral predictor; r = 0.52 applies to intention formation only. Both are statistically significant (p < .001).
Advertencias
Las cifras de acción e inacción provienen de diferentes poblaciones clínicas: un meta-análisis de pacientes con cáncer de próstata localizado (en su mayoría hombres mayores) versus un estudio de sobrevivientes jóvenes de cáncer de mama. La cifra del 20% de arrepentimiento por acción es específica del arrepentimiento por decisión de tratamiento después de cáncer detectado por PSA — probablemente sobreestima el arrepentimiento por diagnóstico temprano en general, ya que el cribado de cáncer de próstata es el área más controvertida del debate sobre sobrediagnóstico. La tasa específica de inacción (25,2%) se deriva de Friedman et al.: 42,5% de la muestra expresó cualquier arrepentimiento, y 59,2% de esos arrepentimientos fueron sobre inacciones (42,5% × 59,2% = 25,2%). La entrada anterior incorrectamente usó el total del 42,5% como la tasa de inacción. El meta-análisis Brewer muestra que el arrepentimiento por inacción anticipado correlaciona con el comportamiento de salud real en r = 0,29. La delta revisada (−0,052) sugiere que la brecha entre arrepentimiento por acción e inacción es más estrecha de lo declarado anteriormente — el diagnóstico temprano conlleva costos de arrepentimiento significativos (efectos secundarios del sobretratamiento) que parcialmente compensan el arrepentimiento por inacción.
