Facts and Myths About Stage Migration: Should the Will Rogers Phenomenon Ride off into the Distance?

The need for accurate diagnosis is a fundamental tenet of medical practice. Over the years the diagnostic process has progressed from simple observation to increasingly complex paradigms involving investigative procedures extending from blood tests to advanced imaging technologies. Each independent piece of information refines the diagnosis and contributes to guiding therapeutic choices. Nevertheless, health technology assessment agencies, supported by some clinical opinion-leaders, maintain that new technologies should only be approved if it can be shown that they improve patient outcomes, by which they generally mean survival as though this is the only beneficial outcome of an improved diagnosis [1,2].