While screening for asymptomatic cancer has become one of the principal clinical
activities of primary care physicians, patients are generally not involved directly
in screening decisions. To help physicians better communicate the potential benefits and burdens of cancer screening, this article concisely presents information necessary for patients to make a reasoned decision as to whether to proceed with screening:
the probability of developing cancer, the operating characteristics of available screening tests, the
likelihood that screening will result in an improved outcome for the individual patient, and the
potential burdens associated with screening. Screening tests for breast, colorectal, cervical, and
prostate cancers are reviewed, including mammography, clinical breast examination, fecal occult
blood testing, Papanicolaou smear, digital rectal examination, and prostate-specific antigen. Better communication about cancer screening will promote shared decision making—a central tenet
of the physician-patient relationship.
(Arch Intern Med. 1996;156:1069-1072)
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