ASCO's Top 5 Oncology List

In 2012, the American Society of Clinical Oncology (ASCO) participated in the American Board of Medicine Foundation’s Choosing Wisely Campaign, which sought to identify tests and procedures that offer little or no benefit to patients. ASCO elicited current committee members to offer suggestions for a 2013 list of these tests and procedures, and removed duplicates, researched the literature, and used its Value in Cancer Task Force to trim the list to 11 items, which were then voted upon by ASCO’s leadership.

The 2013 top 5 list includes:

1. Overmedicating for nausea: patients receiving chemotherapy regimens with a low or moderate emetogenic risk should not receive antiemetics intended for use with a regimen that has a high emetogenic risk.
2. Overuse of chemotherapy: multiple drug regimens should not be used to treat metastatic breast cancer when one drug regimens have similar outcomes and lower cost (the exception is when the patient requires a rapid response to relieve tumor-related symptoms).
3. Inappropriate use of imaging tests: PET and PET-CT scanning should not be used to routinely monitor patients after initial treatment, unless there is high-level evidence that PET or PET-CT imaging will change the outcome.
4. Unwarranted screening: PSA testing should not be performed for prostate cancer screening in men with no symptoms and a life expectancy of less than 10 years.
5. Misuse of treatments: targeted therapy intended for use against a specific genetic aberration should not be used unless the patient’s tumor cells have the specific biomarker that predicts an effective response to the targeted therapy.

Reference

Schnipper LE, Lyman GH, Blayney DW, et al. American Society of Clinical Oncology 2013 top five list in oncology. J Clin Oncol 2013; published ahead of print on 10/29/13 as 10.1200/JCO.2013.53.3943.