Most US cancer prevention and screening recommendations do not provide adequate information for making informed care decisions. A study published in the Journal of the National Cancer Institute found that most guidelines did not quantify benefits and harms or were unable to be presented in an even manner.1
Cancer prevention and screening guidelines are intended to present benefit-harm information to clinicians so they can relay this information to patients leading to educated decisions regarding their care. In this study, researchers assessed how benefits and harms information is presented in US guidelines for cancer prevention and screening interventions.
Researchers, led by Tanner J. Caverly, MD, MPH, Veterans Affairs Medical Center, reviewed cancer screening and prevention guidelines from the US Preventive Services Task Force, the American Cancer Society, the American College of Physicians, the National Comprehensive Cancer Network, and other US guidelines within the National Guidelines Clearinghouse between November 20, 2013, and January 1, 2014, with updates to the guidelines through July 1, 2015. Specifically, they looked for statements regarding improvements in clinically important outcomes that supported use of cancer screening and prevention services; then used descriptive statistics to evaluate the guideline data and how the benefit/risk information was presented.
Their review of 32 guidelines found 55 recommendations for using interventions to prevent or detect breast, prostate, colon, cervical, and lung cancers. Of the 55 recommendations, 39% were given a comparable rating, 14.5% were given an incomplete rating, and 54.5% were given an asymmetric rating.
The researchers acknowledge that absolute effects are difficult to know, but guidelines should at least estimate the absolute benefits and harms of recommended screening and prevention interventions.
“Clarity about benefits and harms would promote more accurate perceptions about important outcomes and support clinician and patient decision-making regarding whether an intervention is appropriate given the context and the patient’s preferences,” the authors wrote.
1. Caverly TJ, Hayward RA, Reamer E, et al. Presentation of benefits and harms in US cancer screening and prevention guidelines: systematic review. J Natl Cancer Inst. 2016;108(6):djv436.