Ronald Adler, MD

[Ronald Adler, MD @AdlerRonald]

@depresseddancer @mata_bata @d_galasinski Cervical cancer screening (Pap smears) is actually the best cancer screening program we have. You should do that one, but not too often. US recommendations are for every five years, assuming it also includes a test for HPV. The case for other cancer screening is much weaker.

[Ronald Adler, MD @AdlerRonald]

@mata_bata Way too many clinicians are not aware. Clinicians, students, citizens, and policymakers need to understand this: cancer screening involves trade-offs. Individual patients should decide based on the best evidence and their own values and preferences

[Ronald Adler, MD @AdlerRonald]

@GenBois @iona_heath @wiserhealthcare @MaryOKeeffe007 @ebmgatineau @drjohnbrodersen @raymoynihan @medmyths @FrederikMartiny @iArnavAgarwal @DrDavidWarriner Yes: too many guidelines suffer from being excessively reductionistic and fail to value the context of whole person orientation. That’s what happens when they are written by partialists (sub specialists).

[Ronald Adler, MD @AdlerRonald]

Thank you for sharing this story and your thoughtful observations

[André Picard @picardonhealth]

Please indulge me for a rare (but brief) thread of personal comments.
I was on a city bus in Copenhagen early this morning. A young man clearly suffering from mental illness was screaming angrily. Not an unusual occurrence on urban transport. Passengers ignored him. 1/

[Ronald Adler, MD @AdlerRonald]

@oncology_bg @SRochman Yes. Don’t just do something. Stand there!

[Ronald Adler, MD @AdlerRonald]

@grepmeded My book, Cancer Screening Decisions: A Patient-Centered Approach, includes decision aids for screening for breast, lung, colorectal, and prostate cancers. The colorectal section compares data for colonoscopy vs stool testing. The breast cancer section includes 3 age cohorts

[Ronald Adler, MD @AdlerRonald]

@MichaelBaum11 @VinayPrasadMD @carethatmatters So am I. Let’s connect

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Cancers are heterogeneous. There is much better evidence for cervical and colorectal cancer screening than breast because they have detectable, slow-growing precursors #cancerscreeningdecisions

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Is it ethical to promote cancer screening without describing the potential harms?? #SharedDecision-making #CancerScreeningDecisions @CareThatMatters #PODC2018

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD When it comes to screening mammography, women should understand the benefits and risks, then make an informed choice. And don’t grade PCPs on what women decide! #SharedDecision-making #CancerScreeningDecisions @carethatmatters

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Many “breast cancer survivors” were overdiagnosed with harmless cancers (turtles) which would never cause harm: cancer TREATMENT survivors #cancerscreeningdecisions @preventingodx #overdiagnosis

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Breast cancer mortality benefits in a population are small — and far outnumbered by the harms, including FALSE POSITIVES and OVERDIAGNOSIS #cancerscreeningdecisions #shareddecisionmaking @PreventingODx

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Doing more screening mammograms produces more women diagnosed with — and treated for breast cancer, NOT improved breast cancer mortality #cancerscreeningdecisions #overdiagnosis #PODC2018

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Screening mammography should be a personal choice informed by these facts and the personal values and preferences of each individual woman #shareddecisionmaking #cancerscreeningdecisions #carethatmatters

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Screening provides NO ALL-CAUSE MORTALITY BENEFIT. The breast cancer-specific mortality benefit is tiny: 8 per 10,000 women in their 50s! #cancerscreeningdecisions #lowvaluecare

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Breast cancer mortality has been improved by advances in treatment, NOT screening #cancerscreeningdecisions #lowvaluecare

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Truly advocating for women means protecting them from the harms of low-value screening: >60% get false positives! OVERDIAGNOSIS! #cancerscreeningdecisions @LownInstitute #PODC2018 @PreventingODx #overdiagnosis

[Ronald Adler, MD @AdlerRonald]

@VinayPrasadMD Love the Tweetorial. These facts have been out there for years, but drowned out by those who treat mammograms as every woman’s obligation #cancerscreeningdecisions #lowvaluecare

[Ronald Adler, MD @AdlerRonald]

@kennylinafp @aafp The best CRC screening test is the one that gets done. Colonoscopy offers only tiny benefits over stool testing, but with substantially more burden and risk. We should help patients make choices informed by their own values and preferences. #CancerScreeningDecisions