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October 22, 2007

Maximizing Informed Cancer Screening Decisions

Arch Intern Med. 2007;167(19):2027-2028. doi:10.1001/archinte.167.19.2027

Most public health campaigns and quality improvement initiatives in the United States have focused on maximizing cancer screening rates rather than on maximizing informed cancer screening decisions. For example, although it is nearly impossible to read a magazine, ride public transportation, or watch television without seeing a public service announcement promoting some form of cancer screening, very few of these announcements provide accurate, balanced information about the pros and cons of screening. Most communicate a 1-sided message that cancer screening is always the right thing to do.1 Although such messages have the positive effect of reducing screening disparities among persons who are likely to benefit, these messages have the detrimental effect of discouraging meaningful discussions about the risks and benefits of screening with persons in whom screening efficacy is less clear (eg, persons of advanced age or those with multiple comorbidities). Similarly, performance measures that equate ordering a screening test with high-quality health care discourage physicians from discussing the risks of screening with patients and minimize the importance of informed cancer screening decisions.2

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