Less is more: inverting the paradigm across the cancer care continuum.

Abstract

Cancer care often operates under the assumption that 'more is better', resulting in frequent testing, intensive treatments, and constant follow-up. However, this approach has unintended consequences and places significant burdens on patients, providers, and healthcare systems. At the same time, cancer care is evolving rapidly and the number of cancer survivors continues to grow, highlighting the urgent need for reform.In the Netherlands, important efforts are taking place to de-escalate and de-implement ineffective practices across the cancer care continuum, from screening to palliative care. The purpose of this viewpoint is to highlight these efforts and stimulate reflection across disciplines. Building on these examples, we propose practical strategies for all stakeholders, from patients to payers and policymakers, to help reduce overuse and prioritise value over volume. Through this work, we challenge the existing paradigm and advocate for a shift toward a 'less is more' approach in cancer care. This viewpoint received no funding.