Much of clinical oncology hinges on the assessment, management, and communication of risk. Screening and genetic testing help identify future cancer risk; treatment decisions involve weighing competing risks; and early-phase clinical trials help determine acceptable risk of new therapies. Of course, in the current COVID-19 pandemic, oncologists have been forced to consider the risk of virus exposure among patients receiving ongoing treatment. When attempting to communicate about risk with patients in these contexts, the first instinct is to provide information that will help them think about risk effectively and then act accordingly. Yet doing so makes the implicit assumption that people really do “think” about risk—that is, that they devote logical reason to the exercise. Although a sensible assumption, much research in decision science does not support it. People often construct risk estimates and other relevant judgments such as preferences de novo, struggle with numerical information, and respond “don’t know” when given such an option on surveys in which they are asked to estimate their risk.1 Moreover, attempts to communicate personalized risk in clinical and other settings often reveal little to no effect on risk-reducing behaviors.2
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Klein WMP, Ferrer RA, Kaufman AR. How (or Do) People “Think” About Cancer Risk, and Why That Matters. JAMA Oncol. Published online May 21, 2020. doi:10.1001/jamaoncol.2020.0170
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