231956 Cancer Screening Guideline Challenges: Methods, Communication, and Application

Monday, November 8, 2010 : 2:30 PM - 2:50 PM

Stephen Taplin, MPH, MD , Applied Cancer Screening Branch, Div of Cancer Control & Population Sciences, National Cancer Institute, National Institutes for Health, DHHS, Bethesda, MD
Ned Calonge, MD, MPH, PhD , Colorado Department of Public Health and Environment, Denver, CO
Bradford W. Hesse, PhD , Health Communication and Informatics Research Branch, National Cancer Institute, Rockville, MD
Jonathan Fielding, MD, MPH , Department of Public Health, Los Angeles County, Los Angeles, CA
The United States Preventive Services Task Force received substantial attention when it released a new recommendation in November 2009. Over the last 20 years, as experience increased with screening for breast, cervical, colon, and prostate cancer, there has been growing controversy about it benefits and concern about its adverse outcomes including false positive tests and over-diagnosis. Simultaneously there is a growing popular faith in early detection. The USPSTF experience in the fall of 2009 was born out of these conflicting trends and raised questions about methodological approaches to screening guideline development, the role of communication, and the challenge public health practitioners face in practice when guidelines appear to differ. This session will discuss considerations in cancer screening guideline development, communication, and application. The overall goal of the session is to contribute to improvement in the development and application of cancer screening guidelines. The guideline development method of the USPSTF will be reviewed, and questions about new methods and approaches will be highlighted to provide greater insight and data for guideline developers. Key issues such as the use of simulation modeling, the number needed to screen versus the number needed to invite to screening to save one life, and the calculation of “net benefit” will be addressed. Research paths for better understanding in how to communicate effectively about cancer screening guideline development and implementation will be presented. Trends in lay understanding of screening recommendations, and considerations in communicating guideline changes to lay audiences and the media will be highlighted. Responsibilities and challenges of public health departments who need to interpret the science, the recommendations, and the reality of disparate use of cancer screening services across the US population they serve will be presented. Further, how this role may change as health care reform becomes reality will be discussed.

Abstracts and Speakers: Methods and methodology guideline development by Chair, USPSTF (20 minutes) Communicating cancer guidelines by Chief,Health Communication and Informatics Research, Branch Behavioral Research Program,DCCPS, NCI. (20 minutes) Applying cancer guidelines in practice by Director and Health Officer, LA County Department of Public Health and Professor at the UCLA school of Public Health and Medicine. (20 minutes)

Discussion: (30 min) This session will be moderated by Senior Scientist and the Acting Chief for the Applied Cancer Screening Research Branch at NCI's Division of Cancer Control and Population Sciences.

Learning Areas:
Basic medical science applied in public health
Clinical medicine applied in public health
Communication and informatics
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
1. To identify 2 methodological issues in guideline development that could be explored and resolved through further research 2. To identify 2 specific steps guideline developers could consider to maximize the clarity of their communication to lay audiences, and one area of needed research 3. To identify 2 specific activities public health departments can undertake in the face of guideline controversies that will improve their ability to meet their responsibilities and one area where research is needed

Keywords: Cancer Screening, Methodology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have spent more than 20 years doing cancer screening research and implementation. I currently am a branch chief within the National Cancer Institute and a senior scientist there.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.