How much overdetection in cancer screening is acceptable?

A paper in The BMJ, “People’s willingness to accept overdetection in cancer screening: population survey,” paints a picture of how difficult is the challenge of trying to inform and educate patients and health care consumers about over detection.

The study tried to address what level of overdetection people would find acceptable in screening for bowel, breast and prostate cancer.  The researchers conclude:

“People have highly variable views on how much overdetection is acceptable in cancer screening. They should therefore be informed about the risk of overdetection and its consequences before deciding to participate. To enable people to do this properly, we need to get better at quantifying harms and benefits.”

In this video, one of the researchers, Dr. Ann Van den Bruel of the University of Oxford explains the analysis.


There were several mentions of potential media influence in the paper:

  • “One could argue that it is impossible to convey all important information in one leaflet. General awareness about overdetection could be improved by mass media campaigns. Such campaigns have the additional benefit of reaching both the general public and clinicians, as evidence seems to suggest that clinicians have an equally poor understanding of diagnostic accuracy. In the presence of an ongoing education campaign, leaflets with invitations for cancer screening could then be more explicit about the likelihood and consequences of overdetection for that particular screening.”
  • “Longitudinal studies could provide more insight into whether people’s individual acceptability varies on the basis of personal experiences, media coverage of high profile patients with cancer, etc.”


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