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Don’t perform routine colonoscopic surveillance every year in patients following their colon cancer surgery*
Choosing Wisely Canada
Canadian Association of Medical/Radiation/Surgical Oncology and Can. Partnership Against Cancer
*frequency should be based on the findings of the prior colonoscopy and corresponding guidelines.
For further information please visit the website of the initiative (link below)
Avoid chemotherapy and instead focus on symptom relief and palliative care in patients with advanced cancer unlikely to benefit from chemotherapy (e.g., performance status 3 or 4)
Choosing Wisely Canada
Canadian Association of Medical/Radiation/Surgical Oncology and Can. Partnership Against Cancer
For further information please visit the website of the initiative (link below)
ver más ... 2014Don’t perform routine cancer screening, or surveillance for a new primary cancer, in the majority of patients with metastatic disease
Choosing Wisely Canada
Canadian Association of Medical/Radiation/Surgical Oncology and Can. Partnership Against Cancer
Screening for cancer can be lifesaving in otherwise healthy at-risk patients. While screening tests lead to a mortality benefit which emerges years after the test is performed, they expose patients to immediate potential harms. In general, patients with metastatic cancer have competing mortality risks that would outweigh the mortality benefits of screening as demonstrated in healthy patients. In fact, patients with metastatic disease may be more likely to experience harm since patients with ...
ver más ... 2014Don’t order test to detect recurrent cancer in asymptomatic patients if there is not a realistic expectation that early detection of recurrence can improve survival or quality of life.
Choosing Wisely Canada
Canadian Association of Medical/Radiation/Surgical Oncology and Can. Partnership Against Cancer
In some specific situations, the early detection of cancer recurrence (local and/or distant) may increase the likelihood of successful subsequent curative treatment. However, in many circumstances, earlier knowledge of recurrence does not improve outcome. As such, it is important to balance the information that can come from advanced testing with what is best for the individual patient. Specifically, the need for patient reassurance should be balanced against the anxiety and uncertainty ...
ver más ... 2014Don’t repeat chest X-rays when screening exposed workers for asbestosis unless clinical indications are present
Choosing Wisely Canada
Occupational Medicine Specialists of Canada - Canadian Medical Association - University of Toronto
Asbestosis generally becomes manifest clinically 15-20 years after the onset of exposure. High resolution CT (HRCT) is more sensitive than both chest radiography and conventional CT for detecting parenchymal fibrosis (asbestosis) but a normal HRCT scan cannot completely exclude asbestosis. Given the long latency between asbestos exposure and asbestosis and given that no effective treatment is available to improve the outcome, screening and early detection of asbestosis is unlikely to allow any ...
ver más ... 2014