15 May 2014

Unnecessary cancer treatments rare in US

A study debunks the misconception that cancer patient demands lead to unnecessary tests and treatments – a major source of higher health care costs in the US.


Cancer patients rarely demand or receive unnecessary tests and treatments, a new study says.

Researchers surveyed 26 cancer specialists and nurse practitioners shortly after they had met with a total of 2 050 patients at the Abramson Cancer Centre at the University of Pennsylvania.

The health care providers were asked how often patients requested or demanded tests and treatment, whether those requests were appropriate, whether they were granted, and why.

Read: Access to cancer care: what do we need to do?

"The results from this new study help debunk many of the misconceptions people have about patient demands leading to unnecessary tests and treatments as a major source of higher health care costs in the US," study author Dr Keerthi Gogineni, an instructor in the haematology-oncology division at the cancer centre, said in an American Society of Clinical Oncology (ASCO) news release.

Requests appropriate

"In this study, inappropriate cancer patient demands were uncommon, and in less than 1% of the cases did providers order an inappropriate treatment or test when requested by patients," she said.

"Clinicians felt that the majority of patient-directed requests were appropriate. The data suggests that rather than being driven by patients to employ low-value, high-cost care, most of the time oncologists and nurse practitioners incorporated patients' requests into a suitable plan of action," Gogineni added.

The study was released ahead of the ASCO annual meeting in Chicago. It will be formally presented at the meeting. Research should be viewed as preliminary until published in a peer-reviewed medical journal.

A Penn Medicine study released last year found that more than 80% of the general public, 70% of doctors and 69% of patients believed that doctors and hospitals gave unnecessary tests and treatments, and more than 50% believed that patients asked for unnecessary tests and treatments.

"Rightfully, there is a big push towards more cost-effective care," Gogineni said. "Oncology in particular has been under the lens because of expensive tests and treatments that sometimes have marginal positive effects. So it's important to show the influence of demands and requests, which appear to be very uncommon among cancer patients – and most likely do not drive overutilisation of high-cost or low-value medical services."

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