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Screening for cancer: advice for high-value care from the American College of Physicians.

Abstract

BACKGROUND

Cancer screening is one approach to reducing cancer-related morbidity and mortality rates. Screening strategies vary in intensity. Higher-intensity strategies are not necessarily higher value. High-value strategies provide a degree of benefits that clearly justifies the harms and costs incurred; low-value screening provides limited or no benefits to justify the harms and costs. When cancer screening leads to benefits, an optimal intensity of screening maximizes value. Some aspects of screening practices, especially overuse and underuse, are low value.

METHODS

Screening strategies for asymptomatic, average-risk adults for 5 common types of cancer were evaluated by reviewing clinical guidelines and evidence syntheses from the American College of Physicians (ACP), U.S. Preventive Services Task Force, American Academy of Family Physicians, American Cancer Society, American Congress of Obstetricians and Gynecologists, American Gastroenterological Association, and American Urological Association. "High value" was defined as the lowest screening intensity threshold at which organizations agree about screening recommendations for each type of cancer and "low value" as agreement about not recommending overly intensive screening strategies. This information is supplemented with additional findings from randomized, controlled trials; modeling studies; and studies of costs or resource use, including information found in the National Cancer Institute's Physician Data Query and UpToDate. The ACP provides high-value care screening advice for 5 common types of cancer; the specifics are outlined in this article. The ACP strongly encourages clinicians to adopt a cancer screening strategy that focuses on reaching all eligible persons with these high-value screening options while reducing overly intensive, low-value screening.

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  • Publisher Full Text
  • Authors

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    Source

    Annals of internal medicine 162:10 2015 May 19 pg 718-25

    MeSH

    Adult
    Aged
    Asymptomatic Diseases
    Breast Neoplasms
    Colorectal Neoplasms
    Cost-Benefit Analysis
    Early Detection of Cancer
    Female
    Humans
    Male
    Mass Screening
    Middle Aged
    Ovarian Neoplasms
    Practice Guidelines as Topic
    Prostatic Neoplasms
    Risk Assessment
    Uterine Cervical Neoplasms
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    25984847

    Citation

    Wilt, Timothy J., et al. "Screening for Cancer: Advice for High-value Care From the American College of Physicians." Annals of Internal Medicine, vol. 162, no. 10, 2015, pp. 718-25.
    Wilt TJ, Harris RP, Qaseem A, et al. Screening for cancer: advice for high-value care from the American College of Physicians. Ann Intern Med. 2015;162(10):718-25.
    Wilt, T. J., Harris, R. P., & Qaseem, A. (2015). Screening for cancer: advice for high-value care from the American College of Physicians. Annals of Internal Medicine, 162(10), pp. 718-25. doi:10.7326/M14-2326.
    Wilt TJ, et al. Screening for Cancer: Advice for High-value Care From the American College of Physicians. Ann Intern Med. 2015 May 19;162(10):718-25. PubMed PMID: 25984847.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Screening for cancer: advice for high-value care from the American College of Physicians. AU - Wilt,Timothy J, AU - Harris,Russell P, AU - Qaseem,Amir, AU - ,, PY - 2015/5/19/entrez PY - 2015/5/20/pubmed PY - 2015/7/24/medline SP - 718 EP - 25 JF - Annals of internal medicine JO - Ann. Intern. Med. VL - 162 IS - 10 N2 - BACKGROUND: Cancer screening is one approach to reducing cancer-related morbidity and mortality rates. Screening strategies vary in intensity. Higher-intensity strategies are not necessarily higher value. High-value strategies provide a degree of benefits that clearly justifies the harms and costs incurred; low-value screening provides limited or no benefits to justify the harms and costs. When cancer screening leads to benefits, an optimal intensity of screening maximizes value. Some aspects of screening practices, especially overuse and underuse, are low value. METHODS: Screening strategies for asymptomatic, average-risk adults for 5 common types of cancer were evaluated by reviewing clinical guidelines and evidence syntheses from the American College of Physicians (ACP), U.S. Preventive Services Task Force, American Academy of Family Physicians, American Cancer Society, American Congress of Obstetricians and Gynecologists, American Gastroenterological Association, and American Urological Association. "High value" was defined as the lowest screening intensity threshold at which organizations agree about screening recommendations for each type of cancer and "low value" as agreement about not recommending overly intensive screening strategies. This information is supplemented with additional findings from randomized, controlled trials; modeling studies; and studies of costs or resource use, including information found in the National Cancer Institute's Physician Data Query and UpToDate. The ACP provides high-value care screening advice for 5 common types of cancer; the specifics are outlined in this article. The ACP strongly encourages clinicians to adopt a cancer screening strategy that focuses on reaching all eligible persons with these high-value screening options while reducing overly intensive, low-value screening. SN - 1539-3704 UR - https://www.unboundmedicine.com/medline/citation/25984847/full_citation L2 - https://www.annals.org/article.aspx?doi=10.7326/M14-2326 DB - PRIME DP - Unbound Medicine ER -