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. But that is set to change, at least in Germany.
By the same author, read All women and women’s organisations should tear up the pink ribbons and campaign for honest information, BMJ 2014;348:g2636, 25 April 2014.