The Individualization of Cancer Screening

As the push for individualized patient care grows, a JAMA viewpoint article makes the case for individualizing cancer screening. The article cites evidence of current screening practices and beliefs that fail to account for individual patient characteristics and, as a result, could lead to missed opportunities to screen certain patients while inappropriately screening other patients. To prevent this, the authors suggest that patient characteristics that affect cancer risk and life expectancy (such as age, screening history, and comorbidity status) should be systemically incorporated into screening decisions.

One approach calls for incorporating tools that predict the benefits of patient-based screening directly into electronic medical records. However, this approach is not without challenges. Some patients may opt for a different screening approach than that recommended by prediction tools, while some clinicians may not feel comfortable making screening decisions that differ from quality measure recommendations. Accordingly, the authors suggest that patients should be educated about the benefits and risks associated with screening, and quality measures should be updated to take into account a variety of patient characteristics.

Despite the challenges, individualized cancer screening has the potential to reduce the risks and health care costs associated with unnecessary screening. The Hopkins Program to Individualize Cancer Screening (inCAS) has developed and is testing a prostate cancer clinical decision support tool that takes into account patient characteristics. As these and other tools are disseminated, individualized cancer screening may soon become a reality.

Learn more about inCAS efforts to optimize cancer screening here

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