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Screening for cancer: advice for high-value care from the American College of Physicians.
Ann Intern Med 2015; 162(10):718-25AIM

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.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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 - http://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 -