Towards a paradigm shift in cancer screening: Informed citizens instead of greater participation. Germany aims to stop nudging the public on screening (2015)
Authors
Abstract
Policy on screening people for cancer poses a dilemma: should we aim for higher participation rates or for better informed citizens? The dilemma is that both cannot be had. A focus on informing citizens risks lowering participation rates, because well informed people may realise that for most cancers it is unclear whether the benefits of screening exceed its harms. Historically, screening policies opted for increasing participation and accordingly took measures that made people overestimate the benefits and underestimate the harms. 1 But that is set to change, at least in Germany. The goal of increasing participation rates has been moderately successful. For instance, German breast cancer screening campaigns set a goal of participation of 70 \% of eligible women and reached over 50 \% . Similarly, the NHS Breast Screening Programme in England aimed for an 80 \% participation rate and reached over 70 \% . 2 But campaigns for this screening test and most other cancer screening tests have caused people in rich countries to widely overestimate benefits and underestimate harms. 3 Only 2-4 \% of German and British women understand the benefit of breast cancer screening, while the rest overestimate it 10-fold, 100-fold, or 200-fold or do not know. 4 By comparison, in Russia, where pink ribbon campaigns do not exist and the participation rate is relatively low, 18 \% of women understand the benefits. that, on the basis of a 2013 law on improving the detection of cancer, 5 the goal of informed participatory decision making is now ranked higher than the goal of a maximum participation rate in cancer screening. 6 To change policy so clearly and publicly is unprecedented and represents a potential paradigm shift in screening. Its implementation will require fundamental changes. In my view, these include the following.
Bibliographic entry
Gigerenzer, G. (2015). Towards a paradigm shift in cancer screening: Informed citizens instead of greater participation. Germany aims to stop nudging the public on screening. BMJ, 350:h2175. doi:10.1136/bmj.h2175 (Full text)
Miscellaneous
| Publication year | 2015 | |
|---|---|---|
| Document type: | Article | |
| Publication status: | Published | |
| External URL: | http://dx.doi.org/10.1136/bmj.h2175 View | |
| Categories: | Consumer BehaviorEducationHealthLaw | |
| Keywords: |