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April 13, 2020

Lung Cancer Screening Websites—Balanced Information vs Advertisement

Author Affiliations
  • 1The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
  • 2Norris Cotton Cancer Center, Lebanon, New Hampshire
  • 3The Lisa Schwartz Foundation for Truth in Medicine, Norwich, Vermont
  • 4Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
  • 5National Cancer Institute, National Institutes of Health, Bethesda, Maryland
JAMA Intern Med. 2020;180(6):821-823. doi:10.1001/jamainternmed.2020.0103

In this issue of JAMA Internal Medicine, Clark et al1 report on the quality of lung cancer screening program websites. A total of 162 lung cancer screening websites presented benefit far more than they presented harm (98% presented any benefit vs 48% presented any harm). Apparently only 44% actually quantified benefit, in most cases doing so using relative risk reductions without the base rate (ie, benefit presented as a 20% reduction in lung cancer mortality without defining “20% of what” or giving the absolute risk reduction, which is on the order of approximately 3 fewer deaths per 1000 people at high risk screened over 7 years). This format undermines informed decision-making because the format is confusing for both patients and health care professionals, and is known to exaggerate findings. Less than half (44%) reported the harms of false positives, radiation exposure, incidental findings, or the possibility of overdiagnosis.

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