screening for cancer

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[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]

Classification

Indications

Clinical significance

Interpretation

False positives common:

  • risk for having 1 false positive after 4 tests was 37% among men & 26% among women[3] (sigmoidoscopy among screening tests in this study)
  • risk for undergoing a false-positive-prompted invasive procedure after 4 tests was 17% among men & 12% among women

Notes

only 14% of cancers detected by recommended screening[20]

Screening recommendations met in 62-88% of population; yet > 1/3 of cancers (for which screening is recommended) present at late stages[4]

Overscreening of the elderly?[5][8]

Elderly often prefer hearing[15]: "This test would not help you live longer" vs "You may not live long enough to benefit from this test."

Patients rarely informed of risks for overdiagnosis & overtreatment when discussing cancer screening[6]

Most cancer screening guidelines fail to provide details of both risks & benefits[12]

Harms, including negative psychological consequences, overdiagnosis & false positives are rarely are quantified & reported by cancer screening trials[7]

Only 60% of cancer screening trials report all-cause mortality[7]

There appears to be some question as to whether cancer screening reduces overall mortality[10]

  • patients who are nonadherent to cancer screening recommendations also are likely to be nonadherent to chronic disease prevention & management[17]

physician's order of cancer screening is higher at 8 AM at 5 PM[18]

patient completion of cancer sceening follows a similar pattern

  • 33% for breast screening completion for 8 AM appointment vs 18% for 5 PM appointment[18]

More general terms

More specific terms

Additional terms

References

  1. ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, 15, 16,. 17, 18. American College of Physicians, Philadelphia 1998, 2009, 2012, 2015, 2018.
  2. ↑ Wolff T et al Screening for skin cancer: An update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2009 Feb 3; 150:194. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19189909 <Internet> http://www.ahrq.gov/clinic/uspstf09/skincancer/skincanart.htm
    U.S. Preventive Services Task Force. Screening for skin cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2009 Feb 3; 150:188. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19189908 <Internet> http://www.ahrq.gov/clinic/uspstf09/skincancer/skincanrs.htm
    Petitti DB et al Update on the methods of the U.S. Preventive Services Task Force: Insufficient evidence. Ann Intern Med 2009 Feb 3; 150:199. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19189910
    corresponding NGC guideline withdrawn Dec 2014
  3. ↑ 3.0 3.1 Croswell JM et al, Cumulative Incidence of False-Positive Results in Repeated, Multimodal Cancer Screening Ann Fam Med. 2009 May-Jun;7(3):212-22. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19433838 <Internet> http://www.annfammed.org/cgi/content/full/7/3/212
  4. ↑ 4.0 4.1 Henley SJ et al Surveillance of Screening-Detected Cancers (Colon and Rectum, Breast, and Cervix) --- United States, 2004--2006 Surveillance Summaries Morbidity and Mortality Weekly Report (MMWR) November 26, 2010 / 59(SS09);1-25 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21102407 <Internet> http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5909a1.htm
  5. ↑ 5.0 5.1 Bellizzi KM et al. Prevalence of cancer screening in older, racially diverse adults: Still screening after all these years. Arch Intern Med 2011 Dec 12/26; 171:2031. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22158573
  6. ↑ 6.0 6.1 Wegwarth O and Gigerenze G Overdiagnosis and Overtreatment. Evaluation of What Physicians Tell Their Patients About Screening Harms. JAMA Intern Med. Published online October 21, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24145597 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1754987
  7. ↑ 7.0 7.1 7.2 Heleno B et al. Quantification of harms in cancer screening trials: Literature review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24041703 BMJ 2013;347:f5334 http://www.bmj.com/content/347/bmj.f5334
  8. ↑ 8.0 8.1 Royce TJ et al Cancer Screening Rates in Individuals With Different Life Expectancies. JAMA Intern Med. Published online August 18, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25133746 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1897549
    van Hees F et al The Appropriateness of More Intensive Colonoscopy Screening Than Recommended in Medicare BeneficiariesA Modeling Study. JAMA Intern Med. Published online August 18, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25133641 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1897548
    Gross CP Cancer Screening in Older Persons. A New Age of Wonder. JAMA Intern Med. Published online August 18, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25133660 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1897541
  9. ↑ Wilt TJ, Harris RP, Qaseem A for the High Value Care Task Force of the American College of Physicians. Screening for Cancer: Advice for High-Value Care From the American College of Physicians. Ann Intern Med. 2015;162(10):718-725. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25984847 <Internet> http://annals.org/article.aspx?articleid=2294149
    Harris RP, Wilt TJ, Qaseem A for the High Value Care Task Force of the American College of Physicians. A Value Framework for Cancer Screening: Advice for High-Value Care From the American College of Physicians. Ann Intern Med. 2015;162(10):712-717 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25984846 <Internet> http://annals.org/article.aspx?articleid=2293237
  10. ↑ 10.0 10.1 Prasad V, Lenzer J, Newman DH. Why cancer screening has never been shown to "save lives"
    and what we can do about it. BMJ 2016;352:h6080 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26740343 <Internet> http://www.bmj.com/content/352/bmj.h6080
  11. ↑ 11.0 11.1 11.2 11.3 Orciari Herman A, Sadoughi S, Sofair A Single Blood Test to Detect All Cancers in the Works, Company Says Physician's First Watch, Jan 11, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
    Reuters. Jan 10, 2016 Illumina, partners make $100 million bet to detect cancer via blood test. http://www.reuters.com/article/us-usa-healthcare-illumina-idUSKCN0UO0W920160111
  12. ↑ 12.0 12.1 Young K, Fairchild DG, Di Francesco L Most Cancer Screening Guidelines Fail to Provide Details of Both Benefits and Risks. Physician's First Watch, Feb 24, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org reference to JNCI home page
  13. ↑ Fenton JJ, Cai Y, Weiss NS et al Delivery of cancer screening: how important is the preventive health examination? Arch Intern Med. 2007 Mar 26;167(6):580-5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17389289 Free PMC Article
  14. ↑ Smith RA, Andrews KS, Brooks D et al Cancer screening in the United States, 2017: A review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2017 Feb 7 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28170086 Free Article <Internet> http://onlinelibrary.wiley.com/doi/10.3322/caac.21392/full
  15. ↑ 15.0 15.1 Schoenborn NL, Lee K, Pollack CE et al Older Adults' Views and Communication Preferences About Cancer Screening Cessation. JAMA Intern Med. Published online June 12, 2017. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28604917 <Internet> http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2630754
    Torke AM Talking to Patients About Cancer Screening Cessation. JAMA Intern Med. Published online June 12, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28604923 <Internet> http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2630750
  16. ↑ 16.0 16.1 Phallen J, Sausen M, Adleff V et al Direct detection of early-stage cancers using circulating tumor DNA. Science Translational Medicine. 16 Aug 2017: 9(403):eaan2415 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28814544 <Internet> http://stm.sciencemag.org/content/9/403/eaan2415
  17. ↑ 17.0 17.1 Pierre-Victor D, Pinsky PF. Association of nonadherence to cancer screening examinations with mortality from unrelated causes: A secondary analysis of the PLCO cancer screening trial. JAMA Intern Med 2018 Dec 28 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30592477 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2719426
    Grady D, Parks M. Why is nonadherence to cancer screening associated with increased mortality? JAMA Intern Med 2018 Dec 28 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30592474 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2719419
  18. ↑ 18.0 18.1 18.2 Hsiang EY, Mehta SJ, Small DS et al Association of Primary Care Clinic Appointment Time With Clinician Ordering and Patient Completion of Breast and Colorectal Cancer Screening. JAMA Netw Open. 2019;2(5):e193403. May 10 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31074811 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2733171
    Liss DT, Linder JA Decision Fatigue, Running Late, and Population Health Management - Screening Out of Time. JAMA Netw Open. 2019;2(5):e193402. May 10 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31074806 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2733166
  19. ↑ American College of Physicians Low-value cancer screening may be commonly provided to older U.S. adults. ACP Internist Weekly. Preventive care. August 17, 2021. https://acpinternist.org/weekly/archives/2021/08/17/4.htm
  20. ↑ 20.0 20.1 20.2 Nelson R Screening Tests Diagnose About 14% of All Cancers. Medscape. December 20, 2022 https://www.medscape.com/viewarticle/985896
    NORC. University of Chicago Only 14% of Cancers Are Detected Through a Preventive Screening Test. https://www.norc.org/PDFs/GRAIL/State-Specific%20PCDSs%20chart%201213.pdf
  21. ↑ 21.0 21.1 NEJM Knowledge+ Hematology
  22. ↑ Berry DA. Failure of researchers, reviewers, editors, and the media to understand flaws in cancer screening studies: application to an article in Cancer. Cancer. 2014 Sep 15;120(18):2784-91. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24925345 Free Article
  23. ↑ 23.0 23.1 23.2 23.3 Bretthauer M, Wieszczy P, Loberg M et al Estimated Lifetime Gained With Cancer Screening Tests. A Meta-Analysis of Randomized Clinical Trials. JAMA Intern Med. Published online August 28, 2023. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37639247 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2808648
  24. ↑ 24.0 24.1 24.2 Stewart J Urine Tests Could Be 'Enormous Step' in Diagnosing Cancer. Medscape. May 21, 2024
    Tosoian JJ, Zhang Y, Xiao L et al Development and Validation of an 18-Gene Urine Test for High-Grade Prostate Cancer. JAMA Oncol. 2024 Apr 18. . PMID: https://www.ncbi.nlm.nih.gov/pubmed/38635241 https://jamanetwork.com/journals/jamaoncology/fullarticle/2817657
    Bhambhani C, Kang Q, Hovelson DH et ak ctDNA transiting into urine is ultrashort and facilitates noninvasive liquid biopsy of HPV+ oropharyngeal cancer. JCI Insight. 2024 Feb 8;9(6):e177759. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38516891 PMCID: PMC11018327 Free PMC article. https://insight.jci.org/articles/view/177759
    Debernardi S, Blyuss O, Rycyk D et al Urine biomarkers enable pancreatic cancer detection up to 2 years before diagnosis. Int J Cancer. 2023 Feb 15;152(4):769-780. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36093581 PMCID: PMC9789171 Free PMC article.

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