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IOM Cancer Report Highlights Harmful Care

Cheryl Clark, for HealthLeaders Media, September 12, 2013

Unnecessary testing is a huge issue for authors of the report.

"All the arguments over Obamacare could be solved fairly easily if you just got rid of the unnecessary testing," says George Sledge, MD, another author of the report, Stanford University's Chief of Oncology, and past president of the American Society of Clinical Oncology.

"Everyone agrees," he says, there's a lot of inappropriate care being delivered.

Sledge, a breast cancer specialist, gave an example of unnecessary followup care for breast cancer patients after adjuvant therapy. "Probably for the last 15 years or so, our guidelines said you should not be wasting money on CT scans, bone scans or (tumor marker) blood tests as part of routine surveillance in the absence of symptoms…because we know all those tests don't improve outcomes.

These are extremely expensive, and often produce false positives.

"We actually have level-one evidence [the most reliable kind] to suggest you shouldn't do those, yet every study of breast cancer patients in followup has said that they get overtested. And in my practice, I routinely see patients who have had that routine tumor marker test every three months for years, or bone scans, CT scans, or PET scans once a year," he says.

"We know this is a huge source of waste in our medical systems. And if we would just follow the guidelines, we would save enormous amounts of money and save our patients an enormous amount of grief."

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