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New Report Aims To Help Patients Be More Informed About Cancer Screenings

PHILADELPHIA (WWJ) -- The American College of Physicians is offering advice on cancer screening in a new report.

The goal is for people to be more informed about screenings for the five most common cancers -- breast, colorectal, prostate, cervical and ovarian. Cancer expert Dr. Dale Shepard of the Cleveland Clinic said that they want people to review the guidelines.

"What they've done is come up with recommendations, which oftentimes are a little different than what we've seen in the past, and it's less-frequent screenings," Shepard said. "So, if we can get the right people to screen, even, if it's at a less-frequent basis we're more likely to have success."

In "A Value Framework for Cancer Screening," ACP speculates about pressures that encourage overly intensive low value screening. The paper lists and discusses five general concepts:

  • Screening is a cascade of events rather than a single test.
  • Cancers are heterogeneous. Optimal intensity screening strategies seek to find that subset of abnormalities that has the greatest probability of progressing to cause health problems and that is more treatable at an early, asymptomatic stage.
  • Individuals are heterogeneous. Optimal intensity screening strategies focus on people with sufficient risk of having a potentially fatal cancer who also have low competing health risks from other causes.
  • Although screening leads to important benefits for some cancers and some people, it can also lead to significant harms to many more people than those receiving benefits.
  • Determining the value of screening strategies is complex, but not impossible.

 

Various screening strategies exist for each of the cancers highlighted in the paper. High intensity screening strategies (screening broader populations, more frequently, and/or with more sensitive screening tests) are not necessarily high value care.

"ACP wants smarter screening by informing people about the benefits and harms of screening and encouraging them to get screened at the right time, at the right interval, with the right test," president of the ACP Dr. Wayne J. Riley said. "Many people have a lack of understanding about the trade-offs of screening. Study after study has consistently shown that patients and many physicians overestimate the benefits and are unaware of and/or downplay the potential harms of cancer screening."

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