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Research Letter
July 23, 2020

Scope and Characteristics of Choosing Wisely in Cancer Care Recommendations by Professional Societies

Author Affiliations
  • 1University of Michigan Medical School, Ann Arbor
  • 2Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor
  • 3Department of Surgery, University of Michigan, Ann Arbor
  • 4Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
  • 5Department of Urology, University of Michigan, Ann Arbor
JAMA Oncol. Published online July 23, 2020. doi:10.1001/jamaoncol.2020.2066

In the United States, the cost of cancer care is increasing exponentially, and cancer care–related spending was projected to be $173 billion in 2020.1 A proportion of this expenditure is attributed to unnecessary medical services, which account for an estimated 21% of all health care services provided in the United States.2 Addressing financial toxic effects and wasteful medical practices, the Choosing Wisely campaign is an international multispecialty initiative that aims to reduce the use of unnecessary tests, treatments, and procedures.3 Thus far, more than 80 professional societies have participated in this effort, generating a list of more than 550 examples of unnecessary and low-value services. Oncological and other societies have targeted routine tests and treatments that are associated with increasing health care costs and patient harm without improving quality of life or survival.4 However, the scope of Choosing Wisely recommendations for cancer care is not well defined. This quality improvement study characterizes the scope of these recommendations, focusing on the de-implementation of low-value cancer care, and identifies potential gaps for future work.

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