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On June 12, 2025, we reported on a study published in the journal BMJ Quality & Safety that was designed to assess how long it takes to deimplement low-value cancer screening practices in the US.
The study
Researchers analyzed 6 United States Preventive Services Task Force (USPSTF) Grade D cancer screening recommendations—guidelines advising against specific screening tests in certain populations due to limited or no benefit, or potential harm. They measured the time between guideline publication and de-implementation, defined as a 50% reduction in the use of the practice in routine care.
The findings
The results indicated that the deimplementation of low-value cancer screening practices varies significantly depending on the specific screening and population. Specifically:
The time to reduce cervical cancer screening in women under 21 years of age was approximately 4 years after guideline publication.
For women aged over 65 years, the reduction took about 16 years.
Prostate cancer screening in men aged 70 years and older has not yet reached a 50% reduction since the 2012 guidelines, even after more than a decade.
For ovarian, thyroid, testicular, and pancreatic cancer screenings in asymptomatic adults, there was insufficient evidence to determine the time to deimplementation.
Authors' comments
"Surveillance of low-value cancer screening is sparse, posing a clear barrier to tracking the de-implementation of these screening practices. Improving the systematic measurement of low-value cancer control practices is imperative for assessing the impact of de-implementation on patient outcomes, healthcare delivery and healthcare costs."
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