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.