Most public health campaigns and quality improvement initiatives in the United States have focused on maximizing cancer screening rates rather than on maximizing informed cancer screening decisions. For example, although it is nearly impossible to read a magazine, ride public transportation, or watch television without seeing a public service announcement promoting some form of cancer screening, very few of these announcements provide accurate, balanced information about the pros and cons of screening. Most communicate a 1-sided message that cancer screening is always the right thing to do.1 Although such messages have the positive effect of reducing screening disparities among persons who are likely to benefit, these messages have the detrimental effect of discouraging meaningful discussions about the risks and benefits of screening with persons in whom screening efficacy is less clear (eg, persons of advanced age or those with multiple comorbidities). Similarly, performance measures that equate ordering a screening test with high-quality health care discourage physicians from discussing the risks of screening with patients and minimize the importance of informed cancer screening decisions.2
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 4
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
The Rational Clinical Examination
Why Is It Important to Record an Accurate Family History of Cancer?
The Rational Clinical Examination
Population for Whom Melanoma Screening Should Be Considered
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.