title: Choosing Wisely Canada cancer list: ten low-value or harmful practices that should be avoided in cancer care.
abstract: OBJECTIVE
  Choosing Wisely Canada, modeled after Choosing Wisely in the United States, is intended to identify low-value or potentially harmful practices relevant to the Canadian health care environment. Our objective was to use multidisciplinary, pan-Canadian, physician-based consensus to identify a list of low-value or harmful cancer practices frequently used in Canada.
  
  
  METHODS
  A Task Force convened by the Canadian Partnership Against Cancer included physician representation from the Canadian Society of Surgical Oncology, Canadian Association of Medical Oncologists, and Canadian Association of Radiation Oncology, and an expert advisor. The methodology included four phases: identify potentially relevant items, develop a long list, refine and reduce the long list to a short list, and select and endorse a final list. A framework-driven consensus process and a series of electronic surveys and voting processes were used to capture consensus.
  
  
  RESULTS
  Sixty-six potentially relevant cancer-related practices were identified. The long list (41 practices) was reduced to a short list of 19 practices. Of the 10 practices on the final list, five are completely new, and five are revisions or adaptations of practices from previous US society lists. Six of the 10 involve multiple disease sites, and four are disease-site specific. One relates to diagnosis, six relate to treatment, two relate to surveillance/survivorship, and one practice spans the cancer care continuum.
  
  
  CONCLUSIONS
  The cancer list was developed in partnership with the Canadian Society of Surgical Oncology, Canadian Association of Medical Oncologists, and Canadian Association of Radiation Oncology. Using knowledge translation and exchange efforts, this list should empower patients with cancer and physicians to assist in a targeted conversation about the appropriateness and quality of individual patient care.
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada Gunita.Mitera@partnershipagainstcancer.ca.
authors.forename: Gunita
authors.initials: G
authors.lastname: Mitera
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada.
authors.forename: Craig
authors.initials: C
authors.lastname: Earle
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada.
authors.forename: Steven
authors.initials: S
authors.lastname: Latosinsky
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Booth
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bezjak
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Desbiens
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada.
authors.forename: Guila
authors.initials: G
authors.lastname: Delouya
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada.
authors.forename: Kara
authors.initials: K
authors.lastname: Laing
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada.
authors.forename: Natasha
authors.initials: N
authors.lastname: Camuso
authors.affiliation: Canadian Partnership Against Cancer; Ontario Institute for Cancer Research; Cancer Care Ontario; Canadian Society of Surgical Oncology; Canadian Association of Medical Oncologists; and Canadian Association of Radiation Oncology, Toronto, Ontario, Canada.
authors.forename: Geoff
authors.initials: G
authors.lastname: Porter
mesh_terms: D026683:Advisory Committees; D002170:Canada; D032921:Consensus; D003299:Cooperative Behavior; D003697:Delphi Technique; D006801:Humans; D033183:Interdisciplinary Communication; D008495:Medical Oncology / Q000379:methods* / Q000592:standards; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy*; D061214:Patient Safety / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards; D017064:Process Assessment, Health Care / Q000592:standards; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D019564:Unnecessary Procedures / Q000592:standards