Richard Wender

• Thomas Jefferson University

The American Cancer Society (ACS) recommends that individuals with a cervix initiate cervical cancer screening at age 25 years and undergo primary human papillomavirus (HPV) testing every 5 years through age 65 years (preferred); if primary HPV testing is not available, then individuals aged 25 to 65 years should be screened with cotesting (HPV tes...

Although cancer mortality rates declined in the United States in recent decades, some populations experienced little benefit from advances in cancer prevention, early detection, treatment, and survivorship care. In fact, some cancer disparities between populations of low and high socioeconomic status widened during this period. Many potentially pre...

A summary evaluation of the 2015 American Cancer Society (ACS) challenge goal showed that overall US mortality from all cancers combined declined 26% over the period from 1990 to 2015. Recent research suggests that US cancer mortality can still be lowered considerably by applying known interventions broadly and equitably. The ACS Board of Directors...

Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the current American Cancer Society cancer screening guidelines are summarized, and the most current data from the National H...

Between 1991 and 2015, the cancer mortality rate declined dramatically in the United States, reflecting improvements in cancer prevention, screening, treatment, and survivorship care. However, cancer outcomes in the United States vary substantially between populations defined by race/ethnicity, socioeconomic status, health insurance coverage, and g...

From the mid‐20th century, accumulating evidence has supported the introduction of screening for cancers of the cervix, breast, colon and rectum, prostate (via shared decisions), and lung. The opportunity to detect and treat precursor lesions and invasive disease at a more favorable stage has contributed substantially to reduced incidence, morbidit...

Cancer care delivery is being shaped by growing numbers of cancer survivors coupled with provider shortages, rising costs of primary treatment and follow‐up care, significant survivorship health disparities, increased reliance on informal caregivers, and the transition to value‐based care. These factors create a compelling need to provide coordinat...

In the United States, it is estimated that more than 1.7 million people will be diagnosed with cancer, and more than 600,000 will die of the disease in 2018. The financial costs associated with cancer risk factors and cancer care are enormous. To substantially reduce both the number of individuals diagnosed with and dying from cancer and the costs...

This article summarizes cancer mortality trends and disparities based on data from the National Center for Health Statistics. It is the first in a series of articles that will describe the American Cancer Society's vision for how cancer prevention, early detection, and treatment can be transformed to lower the cancer burden in the United States, an...

Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates from the National Health Interview Survey, and select issues related to cancer screening. In this 2018 update, we also summarize the new American Cancer Society colorectal cancer screening guideline and...

In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. For this guideline update, the American Cancer Society (ACS) used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evalu...

Purpose: Previous studies report infrequent use of shared decision making for prostate-specific antigen (PSA) testing. It is unknown whether this pattern has changed recently considering increased emphasis on shared decision making in prostate cancer screening recommendations. Thus, the objective of this study is to examine recent changes in share...

Answer questions and earn CME/CNE Each year, the American Cancer Society publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, the authors summarize current American Cancer Society cancer screening guidelines, describe...

In 1996, the Board of Directors of the American Cancer Society (ACS) challenged the United States to reduce what looked to be possible peak cancer mortality in 1990 by 50% by the year 2015. This analysis examines the trends in cancer mortality across this 25-year challenge period from 1990 to 2015. In 2015, cancer death rates were 26% lower than in...

In Reply Dr Anderson and colleagues claim that the ACS breast cancer screening guideline overstepped the boundaries of evidence by no longer recommending routine CBE in average-risk women. The boundary that allegedly was crossed is that the effect of not doing CBE has never been studied. This logic stands the principle of evidence-based medicine on...

Obstet Gynecol Surv 2016;71(3):153–155 The aim of this updated American Cancer Society (ACS) guideline was to provide guidance and flexibility for women at average risk for breast cancer about when to start and stop screening mammography and how frequently screening should be performed. Since the last ACS update on breast cancer screening in 2003,...

Answer questions and earn CME/CNE Each year the American Cancer Society (ACS) publishes a summary of its guidelines for early cancer detection, data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, we summarize current ACS cancer screening guidelines, including the update of the brea...

Importance Breast cancer is a leading cause of premature mortality among US women. Early detection has been shown to be associated with reduced breast cancer morbidity and mortality. Objective To update the American Cancer Society (ACS) 2003 breast cancer screening guideline for women at average risk for breast cancer.Process The ACS commissione...

Answer questions and earn CME/CNE Screening to detect polyps or cancer at an early stage has been shown to produce better outcomes in colorectal cancer (CRC). Programs with a population-based approach can reach a large majority of the eligible population and can offer cost-effective interventions with the potential benefit of maximizing early cance...

A recent study estimates that 277,000 colorectal cancer (CRC) cases and 203,000 CRC deaths will be averted between 2013 and 2030 if the National Colorectal Cancer Roundtable goal of increasing CRC screening prevalence to 80% by 2018 is reached. However, the number of individuals who need to be screened (NNS) to achieve this goal is unknown. In this...

Community health centers are uniquely positioned to address disparities in colorectal cancer (CRC) screening as they have addressed other disparities. In 2012, the federal Health Resources and Services Administration, which is the funding agency for the health center program, added a requirement that health centers report CRC screening rates as a s...

Answer questions and earn CME/CNE Findings from the National Cancer Institute's National Lung Screening Trial established that lung cancer mortality in specific high‐risk groups can be reduced by annual screening with low‐dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the...

Obesity increases the risk of many cancers including colorectal cancer (CRC). This is secondary data analysis of the 2010 National Health Interview Survey data. A total of 9360 obese and overweight participants, aged 50 to 80 years, were analyzed according to their perception of their personal cancer risk. Having a perception of increased risk for...

The concept of the patient-centered medical home (PCMH) has been widely embraced as a foundation for the transformation of health care delivery. Recent evaluations of PCMH pilots validate the initial hypothesis that care provided in the PCMH has the potential to result in better health outcomes at lower cost. However, earning recognition or certifi...

In 2012, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published a position statement on the management of hyperglycaemia in patients with type 2 diabetes [1, 2]. This was needed because of an increasing array of anti-hyperglycaemic drugs and growing uncertainty regarding their proper selectio...

Glycemic management in type 2 diabetes mellitus has become increasingly complex and, to some extent, controversial, with a widening array of pharmacological agents now available (1–5), mounting concerns about their potential adverse effects and new uncertainties regarding the benefits of intensive glycemic control on macrovascular complications (6–...

The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. Howev...

Guidelines for cancer screening written by different organizations often differ, even when they are based on the same evidence. Those dissimilarities can create confusion among health care professionals, the general public, and policy makers. The Institute of Medicine (IOM) recently released 2 reports to establish new standards for developing more...

Background. The literature on colorectal cancer (CRC) screening is contradictory regarding the impact of weight status on CRC screening. This study was intended to determine if CRC screening rates among 2005 National Health Interview Survey (NHIS) respondent racial/ethnic and gender subgroups were influenced by weight status. Methods. Univariable...

While consensus has grown that primary care is the essential access point in a high-performing health care system, the current model of primary care underperforms in both chronic disease management and prevention. The Patient Centered Medical Home model (PCMH) is at the center of efforts to reinvent primary care practice, and is regarded as the mos...

Prostate cancer presents a global public health dilemma. While screening with prostate specific antigen (PSA) has led to more men diagnosed with prostate cancer than in previous years, the potential for negative effects from over-diagnosis and treatment cannot be ignored. We reviewed Medline for recent articles that discuss clinical trials, evidenc...

A brief and psychometrically sound scale to measure patients' overall satisfaction with their primary care physicians would be useful in studies where a longer instrument is impractical. The purpose of this study was to develop and examine the psychometrics of a brief instrument to measure patients' overall satisfaction with their primary care phys...

To test the hypothesis that physicians' empathy is associated with positive clinical outcomes for diabetic patients. A correlational study design was used in a university-affiliated outpatient setting. Participants were 891 diabetic patients, treated between July 2006 and June 2009, by 29 family physicians. Results of the most recent hemoglobin A1c...

Objectives This study was designed to investigate psychometric properties of the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and to examine correlations between its scores and measures of overall satisfaction with physicians, personal trust, and indicators of patient compliance. Methods: Research participants included 535...

The first issue of CA: A Cancer Journal for Clinicians was published in November of 1950. On the 60th anniversary of that date, we briefly review several seminal contributions to oncology and cancer control published in our journal during its first decade. CA Cancer J Clin 2010. © 2010 American Cancer Society, Inc.

The US health care system has become increasingly unsustainable, threatened by poor quality and spiraling costs. Many Americans are not receiving recommended preventive care, including cancer screening tests. Passage of the Affordable Care Act in March 2010 has the potential to reverse this course by increasing access to primary care providers, ext...

This paper reports on factors associated with colorectal cancer (CRC) screening decision stage (SDS) in screening-eligible primary care patients. Baseline telephone survey data (i.e., sociodemographic background, CRC screening perceptions, and SDS) were obtained for 1515 patients in a randomized behavioral intervention trial. Respondents reported S...

National Institutes of Health (NIH) funding has contributed to improvements in the health of the nation, but the pace of progress, particularly in the war on cancer, has been frustratingly slow. Departments of family medicine receive less NIH funding than all other specialties. Although numerous factors contribute to low family medicine funding lev...

In 2009, the American Cancer Society (ACS) Prostate Cancer Advisory Committee began the process of a complete update of recommendations for early prostate cancer detection. A series of systematic evidence reviews was conducted focusing on evidence related to the early detection of prostate cancer, test performance, harms of therapy for localized pr...

The use of colonoscopy in colorectal cancer (CRC) screening has increased substantially in recent years. Media messages and changes in insurance reimbursement, as well as new screening guidelines from the American Cancer Society and the US Preventive Services Task Force, have contributed to this increase. Primary care providers (PCPs) are frequentl...

Addressing our current health care crisis will demand 2 forms of health care reform: reform of health care coverage and transformation of health care delivery. Most policy makers have accepted that primary care must play a prominent role in a new health care delivery vehicle. A new concept, the medical home, has emerged as a possible model of how p...

This article describes a joint update of guidelines by the American Cancer Society and the U.S. Multi-Society Task Force on Colorectal Cancer delineating evidence-based surveillance recommendations for patients after polypectomy and colorectal cancer resection. Although there are some qualifying conditions, the following general guidelines apply: a...

Colorectal cancer (CRC) screening is cost-effective but underused. The objective of this study was to determine the cost-effectiveness of targeted and tailored behavioral interventions to increase CRC screening use by conducting an economic analysis associated with a randomized trial among patients in a large, racially and ethnically diverse, urban...

Colorectal cancer screening is underutilized. The objective of the current study was to determine whether targeted and tailored interventions can increase screening use. A total of 1546 primary care practice patients completed a baseline telephone survey and were randomized to 4 study groups: control (387 patients), Standard Intervention (SI) (387...

In 1998, the American Cancer Society (ACS) set a challenge goal for the nation to reduce cancer incidence by 25% over the period between 1992 and 2015. This report examines the trends in cancer incidence between 1992 and 2004. Trends were calculated using data on incident malignant cancer cases from the Surveillance, Epidemiology, and End Results (...

A recommendation from a physician is the most influential factor in determining whether a patient is screened for colorectal cancer. While the vast majority of primary care physicians report that they screen for colorectal cancer, many patients do not receive the recommendation they need. Evidence-based strategies can help the physician ensure that...

The American Cancer Society is calling for a deeper understanding of the meaning of adequate health insurance coverage in our nation's debate about access to care. Ensuring that primary care, prevention, early detection, and quality care are available to all will require health care reform.

Primary care physicians in the United States see more than 80% of new-onset epilepsy cases and provide ongoing care in about half of these. However, in a single year any given primary care physician may see only one or two patients with new-onset seizure disorder and may be uncomfortable classifying, treating, and managing them. Lack of experience...

We wanted to analyze National Institutes of Health (NIH) awards to departments of family medicine. We obtained the list of NIH awards to departments of family medicine in 2003, and collected additional information from the Internet regarding each principal investigator (PI), including whether he or she worked primarily in a core (central) organizat...

The American Cancer Society has challenged the U.S. to reduce cancer mortality rates 50% over the 25 years from 1990 to 2015. The current report is an analysis and commentary on progress toward that goal through 2002, the midpoint of the challenge period. Cancer mortality rates were examined from 1990 through 2002, and projections to the Year 2015...

Major health disparities between men and women persist despite advances in medical technology and attenuation in gender roles and norms. Research has neglected to examine how sex differences influence men's health or to identify the health risks associated with being male. Although being male is a major health determinant and predictor of disease a...

In this first of two articles on new epilepsy guidelines for primary care physicians, the authors present detailed algorithms for the diagnosis and classification of seizure disorders in adults. They discuss the differentiation between generalized and partial seizures and stress that accurate identification is especially important because the type...

In this second of two articles on new epilepsy guidelines for primary care physicians, the authors discuss which treatments are the most effective in adults with this disease. They describe the antiepileptic drugs that are currently approved and elucidate the differences between established and newer options. Detailed algorithms cover pharmacothera...

In this first of two articles on new epilepsy guidelines for primary care physicians, the authors present detailed algorithms for the diagnosis and classification of seizure disorders in adults. They discuss the differentiation between generalized and partial seizures and stress that accurate identification is especially important because the type...

In this second of two articles on new epilepsy guidelines for primary care physicians, the authors discuss which treatments are the most effective in adults with this disease. They describe the antiepileptic drugs that are currently approved and elucidate the differences between established and newer options. Detailed algorithms cover pharmacothera...

No abstract available.

NO abstract available.

Despite national guidelines, studies across the country have shown that many physicians do not regularly engage in tobacco cessation behaviors such as assisting their patients with quitting. This survey study examined tobacco cessation behaviors among physicians in Delaware as part of the state's tobacco control program called Plan for a Tobacco-Fr...

In this issue of Cancer , Chen et al. report outcomes from an integrated model of multiphasic chronic disease screening in Taiwan. The design and outcomes of the Keelung Community‐based Integrated Screening program are noteworthy for several reasons and should reopen the debate not only regarding the worth, but also the protocol for periodic preven...

To determine whether an adequate amount of family history is being collected and recorded by family practitioners to appropriately identify patients at increased risk for cancer. Retrospective chart audit. Charts from 500 randomly chosen patients, 40 to 60 years of age, were audited. Of those charts, 400 were from a large academic family practice a...

Table 3 provides a summary of key recommendations for each cancer site discussed in this chapter. One of the unifying principles of cancer screening is that every clinician or group practice needs to define an explicit screening policy. Resources must then be devoted to implementing this policy, evaluating adherence, and improving performance.

The purpose of the current study was to provide health professionals, professional organizations, policy makers, and the general public with a practical blueprint for increasing the practice of screening for colorectal carcinoma (CRC) and adenomatous polyps over the next decade. The National Colorectal Cancer Roundtable (NCCRT) was founded in 1997...

Rapidly growing interest in colon cancer screening is a crucial first step to identifying and reducing many of the barriers that impede population screening for this common disease. Promoting screening demands health care policy change to increase the percentage of Americans with insurance coverage that includes a colon cancer screening benefit. A...

Updates to the American Cancer Society (ACS) guidelines regarding screening for the early detection of prostate, colorectal, and endometrial cancers, based on the recommendations of recent ACS workshops, are presented. Additionally, the authors review the “cancer-related check-up,” clinical encounters that provide case-finding and health counseling...

Updates to the American Cancer Society (ACS) guidelines regarding screening for the early detection of prostate, colorectal, and endometrial cancers, based on the recommendations of recent ACS workshops, are presented. Additionally, the authors review the "cancer-related check-up," clinical encounters that provide case-finding and health counseling...

Patients commonly receive medical care from multiple providers and confusion as to who is responsible for cancer screening undoubtedly contributes to inadequate recommendations. Effective screening requires successful implementation of a series of steps that begin with the initial discussion of a screening test and proceed through obtaining results...

The majority of primary care practitioners strive to practice prevention; for many the ability to prevent disability and disease is one of the attractions of primary care. The population, as well, believes in preventing disease. Despite broad acceptance, performance is variable; some providers still provide predominantly symptom-oriented care. The...

The role of humor in medicine is becoming increasingly apparent. Humor helps individuals narrow interpersonal and cultural gaps, communicate difficult messages, express frustration and anger, and cope with anxiety. Primary care providers need to be able to interpret humor used by patients and can learn to use humor to create a healing environment....

Despite increasing recognition of the importance of preventive services, such services are not provided in primary care practice as often as recommended. One of the most important reasons is the lack of a systematic, organized approach within practices. The American Cancer Society Ad Hoc Advisory Group on Preventive Health Care Reminder Systems rev...