Overview

• A BMJ Quality & Safety narrative review assessed screening trends for cervical and prostate cancers following USPSTF guideline updates issued between 1996 and 2012.
• Cervical cancer screening in women under 21 fell by 50% within a year of new recommendations, but rates among women over 65 took 13 years to achieve the same decline.
• Despite 2012 guidance against routine prostate screening for men aged 70 and older, screening rates in this group have not yet dropped by half.
• Physician inertia, patient expectations shaped by early-detection messaging and frequent guideline shifts emerged as primary barriers to de-implementing low-value tests.
• The study highlights the need for enhanced data infrastructure and policy reforms to track unnecessary screenings and realign incentives with evidence-based practices.