Cancer Screening
From a litigation perspective, it has been clear since 2011 that failure to offer colorectal or breast cancer screening is negligent. The same cannot be said for much rarer syndromes.
Failure to recommend or perform appropriate cancer screening has become an increasingly significant issue in medical malpractice litigation. For example, a patient presenting with advanced colon cancer and metastatic disease years after reaching screening age may raise important questions regarding whether earlier screening could have detected a premalignant lesion or cancer at a far more treatable stage.
Over the past several decades, routine cancer screening guidelines established by organizations such as the American Cancer Society, the American College of Physicians, and other major medical bodies have become an important component of accepted medical practice. While recommendations vary somewhat among organizations and have evolved over time, by the early 2000s there was broad consensus that average-risk adults should undergo colorectal cancer screening beginning around age fifty, with earlier screening recommended for individuals with elevated risk factors.
The evidence supporting improved outcomes through early detection is particularly strong for breast, cervical, and colorectal cancers. Recommendations surrounding prostate cancer screening have historically been more nuanced because of ongoing debate regarding survival benefit, while standards for lung cancer screening continue to evolve as data supporting CT screening in high-risk populations expands.
Inherited cancer syndromes require even more rigorous screening strategies. Conditions such as Lynch Syndrome, familial adenomatous polyposis (FAP), and BRCA-associated breast and ovarian cancer syndromes may warrant significantly earlier and more aggressive surveillance measures than those recommended for average-risk individuals.
From a litigation perspective, failure to recommend colorectal or breast cancer screening may represent a significant deviation from accepted standards of care, particularly when the delay results in diagnosis at a far more advanced stage of disease. In many colorectal cancer cases, earlier screening might have identified and removed a premalignant polyp years before cancer developed or metastasized.
Questions of causation, prognosis, timing, and standards of care in these matters require careful review of screening history, risk factors, guideline evolution, and the probable natural history of the underlying disease. Dr. Stark provides expert consultation and evidence review in matters involving delayed diagnosis, screening failures, inherited cancer syndromes, and complex oncology-related standards-of-care issues.