Evaluation of Harms Reporting in U.S. Cancer Screening Guidelines
Year: 2022
Type: review
Abstract: BACKGROUND: Cancer screening should be recommended only when the balance between benefits and harms is favorable. This review evaluated how U.S. cancer screening guidelines reported harms, within and across organ-specific processes to screen for cancer. OBJECTIVE: To describe current reporting practices and identify opportunities for improvement. DESIGN: Review of guidelines. SETTING: United States. PATIENTS: Patients eligible for screening for breast, cervical, colorectal, lung, or prostate cancer according to U.S. guidelines. MEASUREMENTS: Information was abstracted on reporting of patient-level harms associated with screening, diagnostic follow-up, and treatment. The authors classified harms reporting as not mentioned, conceptual, qualitative, or quantitative and noted whether literature was cited when harms were described. Frequency of harms reporting was summarized by organ type. RESULTS: Harms reporting was inconsistent across organ types and at each step of the cancer screening process. Guidelines did not report all harms for any specific organ type or for any category of harm across organ types. The most complete harms reporting was for prostate cancer screening guidelines and the least complete for colorectal cancer screening guidelines. Conceptualization of harms and use of quantitative evidence also differed by organ type. LIMITATIONS: This review considers only patient-level harms. The authors did not verify accuracy of harms information presented in the guidelines. CONCLUSION: The review identified opportunities for improving conceptualization, assessment, and reporting of screening process-related harms in guidelines. Future work should consider nuances associated with each organ-specific process to screen for cancer, including which harms are most salient and where evidence gaps exist, and explicitly explore how to optimally weigh available evidence in determining net screening benefit. Improved harms reporting could aid informed decision making, ultimately improving cancer screening delivery. PRIMARY FUNDING SOURCE: National Cancer Institute.
Source: Annals of Internal Medicine
DOI: 10.7326/m22-1139
Authors: Aruna Kamineni, V. Paul Doria-Rose, Jessica Chubak, John M. Inadomi, Douglas A. Corley, Jennifer S. Haas, Sarah C. Kobrin, Rachel L. Winer, Jennifer Elston Lafata, Elisabeth F. Beaber, Joshua S. Yudkin, Yingye Zheng, Celette Sugg Skinner, Joanne E. Schottinger, Debra P. Ritzwoller, Jennifer M. Croswell, Andrea N. Burnett-Hartman
Institutions: Kaiser Permanente Washington Health Research Institute, National Institutes of Health, National Cancer Institute, University of Utah, Kaiser Permanente, Kaiser Permanente Northern California, Massachusetts General Hospital, University of Washington, University of North Carolina at Chapel Hill, Henry Ford Health, UNC Lineberger Comprehensive Cancer Center, Fred Hutch Cancer Center, The University of Texas Health Science Center at Houston, Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Kaiser Permanente Bernard J. Tyson School of Medicine
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Coordinating Center for Population-based Research to Optimize Cancer Screening (PROSPR) (U24), Optimizing Colorectal Cancer Screening PREcision and Outcomes in CommunIty-baSEd Populations (PRECISE), G6374948078, Building CER Capacity: Aligning CRN, CMS, and State Resources to Map Cancer Care, Center for Research to Optimize Precision Lung Cancer Screening in Diverse Populations
OpenAlex ID: W4297094211