Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.
On June 12, 2025, we reported on a study published in BMJ Quality & Safety that was designed to describe the availability of evidence on the deimplementation of low-value cancer screening practices in routine care and measure the time to de-implementation of these practices in routine care in the US.
The study
Researchers analyzed 6 United States Preventive Services Task Force ‘Grade D’ cancer screening practices: (1) cervical cancer screening in women aged <21 years and >65 years, (2) prostate cancer screening in men aged ≥70 years and (3) ovarian, (4) thyroid, (5) testicular and (6) pancreatic cancer screening in asymptomatic adults. They measured the time from a landmark publication supporting the guideline publication and subsequent deimplementation, defined as a 50% reduction in the use of the practice in routine care. The pace of deimplementation was assessed using nationally representative surveillance systems and peer-reviewed literature.
The findings
Reducing cervical cancer screening in women under 21 was achieved within approximately 4 years following guideline updates. Conversely, efforts to curb screening in women over 65 took up to 16 years, with many practices still not significantly reduced. Notably, prostate-specific antigen (PSA)-based screening in men aged 70 and older has yet to achieve a 50% reduction since the 2012 guideline release, indicating persistent overuse.
Investigators did not identify sufficient evidence to measure the time to de-implementation for ovarian, thyroid, testicular and pancreatic cancer screening in asymptomatic adults.
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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