You are using an outdated browser. Please upgrade your browser to improve your experience.
Become a Fellow
ACP offers a number of resources to help members make sense of the MOC requirements and earn points.
Understanding MOC Requirements
Earn MOC points
The most comprehensive meeting in Internal Medicine.
April 11-13, 2019
Internal Medicine Meeting 2019
Prepare for the Certification and Maintenance of Certification (MOC)
Exam with an ACP review course.
Board Certification Review Courses
MOC Exam Prep Courses
Treating a patient? Researching a topic? Get answers now.
Visit AnnalsLearn More
Visit MKSAP 17 Learn More
Visit DynaMed Plus
Ensure payment and avoid policy violations. Plus, new resources to help you navigate the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Access helpful forms developed by a variety of sources for patient charts, logs, information sheets, office signs, and use by practice administration.
ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
© Copyright 2018 American College of Physicians. All Rights Reserved. 190 North Independence Mall West, Philadelphia, PA 19106-1572
Toll Free: (800) 523.1546 · Local: (215) 351.2400
ACP's advice is for average risk adults without
Philadelphia, May 19, 2015 -- In a paper published today in
Annals of Internal Medicine, the American College of
Physicians (ACP) issued advice
for screening average risk adults without symptoms for five common
cancers: breast, colorectal, ovarian, prostate, and
In a companion piece also published in Annals, ACP outlined a
for thinking about the value of varying intensities of cancer
"ACP wants smarter screening by informing people about the
benefits and harms of screening and encouraging them to get
screened at the right time, at the right interval, with the right
test," said Dr. Wayne J. Riley, president, ACP. "Many people have a
lack of understanding about the trade-offs of screening. Study
after study has consistently shown that patients and many
physicians overestimate the benefits and are unaware of and/or
downplay the potential harms of cancer screening."
In "Screening for Cancer," ACP reviewed clinical guidelines and
evidence synthesis issued by the U.S. Preventive Services Task
Force, the American Academy of Family Physicians, the American
Cancer Society, the American Congress of Obstetrics and Gynecology,
the American Gastroenterological Association, the American
Urological Association, and ACP.
"We found much common agreement on high value care screening
among different organizations," said Dr. Tanveer Mir, chair of
ACP's Board of Regents and a member of ACP's High Value Care Task
Force, which developed the papers. "Our advice puts that agreement
together in one convenient place for physicians and patients. Many
major physician organizations are seeking to implement strategies
that best optimize the known benefits and harms of cancer
Various screening strategies exist for each of the cancers
highlighted in the paper. High intensity screening strategies
(screening broader populations, more frequently, and/or with more
sensitive screening tests) are not necessarily high value care. ACP
defines high value care as the delivery of services providing
benefits that make their harms and costs worthwhile. ACP encourages
physicians to implement a health care strategy that focuses on
tests or treatments that improve health, avoid harms, and eliminate
Screening average risk adults ages 50 to 75 for colorectal
cancer with high sensitivity fecal occult blood testing every year
is an example of high value care. Screening women without a cervix
for cervical cancer is an example of low value care.
"The largest harm that can result from overly intense screening
is over-diagnosis and overtreatment," Dr. Riley said. "The more
sensitive the test we use or lower the threshold we establish for
an abnormality the more abnormalities we find -- many of which will
never lead to health problems. But because doctors cannot know
which of these would or would not cause problems, we tend to treat
them. Treatment for cell and tissue abnormalities that will likely
not cause health problems cannot provide benefits."
Prostate cancer, for example, detected with the
prostate-specific antigen (PSA) test never becomes clinically
significant in a patient's lifetime in a considerable proportion of
men. Screening using the PSA test in average risk men under the age
of 50 years or over the age of 69 years can open the door to more
testing and treatment that might actually be harmful. If cancer is
diagnosed, it will often be treated with surgery or radiation,
which increases the risk for loss of sexual function and loss of
control of urination compared to no surgery. This does not apply to
those men considered to be in high risk groups such as African
American men and/or those with a strong family history of prostate
advice applies to adults without symptoms who are at average
In "A Value Framework for Cancer Screening," ACP speculates
about pressures that encourage overly intensive low value
screening. The paper lists and discusses five general concepts:
About ACP's High Value Care Task ForceACP's High Value
Care initiative is designed to help doctors and patients
understand the benefits, harms, and costs of tests and treatment
options for common clinical issues so they can pursue care together
that improves health, avoids harms, and eliminates wasteful
practices. ACP defines High Value Care as the delivery of services
providing benefits that make their harms and costs worthwhile.
ACP's High Value Care Task Force papers focus on value by
evaluating the benefits, harms, and costs of a test or
intervention. Value is not merely cost. Some expensive tests and
treatments have high value because they provide high benefit and
low harm. Conversely, some inexpensive tests or treatments have low
value because they do not provide enough benefit to justify even
their low costs and might even be harmful.
About the American College of Physicians
The American College of Physicians is the largest
medical specialty organization and the second-largest physician
group in the United States. ACP members include 141,000 internal
medicine physicians (internists), related subspecialists, and
medical students. Internal medicine physicians are specialists who
apply scientific knowledge and clinical expertise to the diagnosis,
treatment, and compassionate care of adults across the spectrum
from health to complex illness. Follow ACP on Twitter and Facebook.