ArticleCancer medicine2019
Do doctors who order more routine medical tests diagnose more cancers? A population-based study from Ontario Canada.
Article in Cancer medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Thyroid Cancer Incidence and Trends in United States and Canadian Pediatric, Adolescent, and Young Adults.Cancers · 2025Article
- Trends in thyroid function testing, neck ultrasound, thyroid fine needle aspiration, and thyroidectomies in North-eastern Italy.Journal of endocrinological investigation · 2021Article
- Preventing overuse of laboratory diagnostics: a case study into diagnosing anaemia in Dutch general practice.BMC medical informatics and decision making · 2020Article
- Use and overuse of diagnostic neck ultrasound in Ontario: Retrospective population-based cohort study.Canadian family physician Medecin de famille canadien · 2020Article
- Early Diagnosis of Low-Risk Papillary Thyroid Cancer Results Rather in Overtreatment Than a Better Survival.Frontiers in endocrinology · 2020Review
- Do doctors who order more routine medical tests diagnose more cancers? A population-based study from Ontario Canada.Cancer medicine · 2019Article
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Authors and funding
6 authors.
Funding
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Abstract
backgroundThe overuse of medical tests leads to higher costs, wasting of resources, and the potential for overdiagnosis of disease. This study was designed to determine whether the patients of family doctors who order more routine medical tests are diagnosed with more cancers.
methodA retrospective population-based cross-sectional study using administrative health care data in Ontario Canada. We investigated the ordering of 23 routine laboratories and imaging tests 2008-20012 by 6849 Ontario family physicians on their 4.9 million rostered adult patients. We compared physicians' test utilization and calculated case-mix adjusted observed to expected (O:E) utilization ratios to categorize physicians as Typical, Higher or Lower testers. Age-sex standardized rates (cases/10 000 patient years) and Rate Ratios were determined for cancers of the thyroid, prostate, breast, lymphoma, kidney, melanoma, uterus, ovary, lung, esophagus, and pancreas for each tester group.
resultsThere was wide variation in the use of the 23 tests by Ontario physicians. 26% and 24% of physicians were deemed Higher Testers for laboratory and imaging tests, while 41% and 38% were Typical Testers. The patients of higher test users were diagnosed with more cancers of thyroid (laboratory [RR 1.61, 95% CI 1.39-1.87] and imaging [RR 2.08, 95% CI 0.88-2.30]) and prostate (laboratory [RR 1.10, 95% CI 1.03-1.18] and imaging [RR 1.05, 95% CI 1.00-1.10]).
conclusionThere is a wide variation in the ordering of routine and common medical tests among Ontario family doctors. The patients of higher testers were diagnosed with more thyroid and prostate cancers.
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