1. 1

    Avoid cytotoxic chemotherapy in patients with advanced cancer who are unlikely to benefit from chemotherapy (ECOG performance status 3 or 4) and continue to focus on symptom relief and palliative care

  2. 2

    Do not perform routine cancer screening, or surveillance for a new primary cancer, in the majority of patients with metastatic disease

  3. 3

    Avoid tests (biomarkers and imaging) for recurrent cancer in previously treated asymptomatic patients unless there is evidence that early detection of recurrence can improve survival or quality of life; including avoiding surveillance testing (biomarkers) or imaging (PET, CT and radionuclide bone scans) for asymptomatic individuals who have been treated for breast cancer with curative intent

  4. 4

    Do not perform serum tumour marker tests except to evaluate or monitor a cancer known to produce these markers

  5. 5

    Do not routinely offer pharmacological venous thromboembolism (VTE) prophylaxis to ambulatory outpatients who are undergoing oncological treatment

How this list was developed

A MOGA Evolve working group was established and compiled an initial list of 64 potentially low-value tests, treatments, and other clinical practices in medical oncology, drawing on the results of a desktop review and clinical experience. Following further review by the working group 24 of these items were put forward to the MOGA Executive Committee, who then nominated their top-11.  The details of these 11 items were circulated to all MOGA members for their review and feedback. Respondents assigned a score of 1 to 5 for each item. Scores for each item were averaged and the final top-5 was approved by the MOGA Executive Committee.