Select Media Clips

PSA test part of trend: Fewer screenings for well people USA Today Liz Szabo May 29, 2012 Yet health experts say the recommendations by the U.S. Preventive Services Task Force are a part of a broader trend that's been building for years. People are taking a closer look not just at cancer screenings, but at all medical tests and procedures, says Steven Woloshin, co-director of the Center for Medicine and the Media at the Dartmouth Institute for Health Policy and Clinical Practice. Concern about "overtesting" and "overtreating" patients is growing because of a rising recognition that these interventions often have risks and serious side effects.

"There is something going on, not just in cancer," Woloshin says. "There is some sort of shift, and it's encouraging. It feels like this is the beginning of a sea change in attitudes towards testing, treating and overdiagnosis."

Doctors are taking a "less is more" approach on several fronts.

Last month, for example, nine physicians' groups launched the "Choosing Wisely" campaign to discourage 45 frequently overused tests and procedures. The groups, which included the American College of Cardiology, noted many common interventions are unnecessary, including stress tests during routine annual exams.

Many of these overused tests involve trying to "help the well stay well by looking for things to be wrong," says H. Gilbert Welch, a physician and author of Overdiagnosed: Making People Sick in the Pursuit of Health.

The American College of Radiology also is leading campaigns called Image Wisely, to reduce unnecessary radiation exposure in adults, and Image Gently, to reduce exposure in children. The campaigns address growing concerns over the risk of cancers related to medical radiation, which has been estimated to cause up to 29,000 cancers a year. Researchers estimate that one-third of CT scans may be unnecessary, according to a 2009 report in the Archives in Internal Medicine.

And in the past four years, medical groups have voted to restrict several types of cancer screenings. That's partly because science has evolved to help doctors better understand how cancers progress and how best to use screening technology, and also because doctors better understand the risks and limitations of treatment, says Lisa Schwartz, also co-director at the Dartmouth Center. • In 2008, for example, before the task force voted against the PSA entirely, it recommended offering it only to men under age 75, reasoning that older men would not likely be helped by a test that largely detects slow-growing cancers. • In 2009, the task force recommended against routine mammograms for women under 50, and suggested women over 50 get screened every other year, instead of annually. That recommendation drew fierce protests from women, radiologists and many politicians. • In March, in a less controversial move, the American Cancer Society revised its cervical cancer recommendations, suggesting that women get screened every three years, instead of every year,