Financial incentives have little impact on cancer screening rates

A program to increase cancer screening rates in Canada by providing financial incentives to primary care physicians has had little effect on those screening rates, according to a study published in the July/August issue of the Annals of Family Medicine.

Tara Kiran, M.D., from Keenan Research Centre at St. Michael's Hospital in Toronto, and colleagues determined the program produced little change in screening rates despite the province of Ontario paying more than $100 million in incentives to physicians over a three-year period for hitting targets for cervical, breast and colorectal cancer screening.

The researchers found that while colon cancer screening rates increased 3 percent annually before the incentives were introduced in 2006, they increased by 4.7 percent afterward. However, screening rates for breast and cervical cancer did not significantly change.

The improvement in colon cancer screening rates, the authors said, could be due to several factors, including a lower baseline screening rate, larger financial incentives for colorectal cancer screening, and the fact that Ontario introduced a province-wide media campaign promoting colorectal cancer screening in 2008.

"We all know it's tight financial times," Kiran told The Globe and Mail. "So is this really the best value for our money?"

The result of the study is further evidence that these kinds of incentive bonus payments don't work, Noah Ivers, a family physician and scientist at Women's College Hospital in Toronto, told the Globe and Mail. "[Pay for performance] only makes sense if motivation is the problem and I don't think it is," he said. "When it comes to cancer screening, all the providers are on the same page, everybody wants to get cancer screening done."

To learn more:
- read the study in the Annals of Family Medicine
- see the article in The Globe and Mail