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Cancer screening and accessibility bias: people want screening when informed it saves no lives

Published online by Cambridge University Press:  23 June 2020

NATHAN HODSON*
Affiliation:
Harvard School of Public Health, Boston, MA, USA
*
*Correspondence to: Harvard School of Public Health, 677 Huntington Ave, Boston, MA02115, USA. E-mail: Nhodson@hsph.harvard.edu

Abstract

Some cancer screening programs are built on contentious evidence, but the public are generally positive about screening. Many professional organizations have settled on a fudge: allow the people to decide for themselves. Given the potential limitations of individual decision-making, there is increasing support for helping individuals to make better decisions. This paper presents experimental data supporting the claim that individuals are largely unresponsive to data about screening and base their decisions upon factors that professionals would consider inappropriate reasons for screening. The most plausible explanation for this phenomenon comes from accessibility bias. Professionals can no longer sustain the argument that, with respect to cancer screening, individual choice reflects a meaningful expression of autonomy.

Type
New Voices
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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References

American Cancer Society. (n.d.), American Cancer Society Breast Cancer Screening Guideline. URL: https://www.cancer.org/latest-news/special-coverage/american-cancer-society-breast-cancer-screening-guidelines.html (Accessed 11 08 2019)Google Scholar
Bond, M., Pavey, T., Welch, K., Cooper, C., Garside, R., Dean, S. and Hyde, CSystematic review of the psychological consequences of false-positive screening mammograms’, Health Technol Assess, 2013;17(13):1–vi. doi:10.3310/hta17130CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. (2018), Breast Cancer. What are the benefits and risks of screening? URL: https://www.cdc.gov/cancer/breast/basic_info/benefits-risks.htm (Accessed 11 08 2019)Google Scholar
Collins, K., Winslow, M., Reed, M.W., Walters, S.J., Robinson, T., Madan, J., Green, T., Cocker, H. and Wyld, L (2010), ‘The views of older women towards mammographic screening: a qualitative and quantitative study’, Br J Cancer, 102(10): 14611467.10.1038/sj.bjc.6605662CrossRefGoogle ScholarPubMed
Dolan, P., Hallsworth, M, Halpert, D., King, D. and Vlaev, I. (2010), ‘MINDSPACE: influencing behaviour through public policy’, Cabinet Office and Institute for Government, 2010: p24Google Scholar
Driedger, S.M., Annable, G., Brouwers, M., Turner, D. and Maier, R (2017), ‘Can you un-ring the bell? A qualitative study of how affect influences cancer screening decisions’, BMC Cancer, 17(1):647.10.1186/s12885-017-3596-7CrossRefGoogle Scholar
Fischer, J. and Ravizza, M., (1993, Perspectives on Moral Responsibility, Ithaca: Cornell University Press.Google Scholar
Gigerenzer, G. (2014), ‘Breast cancer screening pamphlets mislead women’, BMJ, 348:g263610.1136/bmj.g2636CrossRefGoogle ScholarPubMed
Goslinga, C. (2015), Movies about cancer. Internet Movie Database.Google Scholar
Gøtzsche, P.C. and Jørgensen, K (2013), ‘Screening for breast cancer with mammography’, Cochrane Database of Systematic Reviews, 6: CD001877. DOI: 10.1002/14651858.CD001877.pub5.Google Scholar
Henriksen, M.J., Guassora, A.D. and Brodersen, J (2015), ‘Preconceptions influence women's perceptions of information on breast cancer screening: a qualitative study’, BMC Res Notes, 8:404.10.1186/s13104-015-1327-1CrossRefGoogle ScholarPubMed
Hewitson, P., Glasziou, P.P., Irwig, L., Towler, B. and Watson, E (2007), ‘Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Cochrane. And Issa IA, Noureddine M. Colorectal cancer screening: An updated review of the available options’, World J Gastroenterol. 2017 Jul 28;23(28):5086–5096.Google Scholar
Ilic, D, Neuberger, MM, Djulbegovic, M and Dahm, P (2013), ‘Screening for prostate cancer’, Cochrane Database Syst Rev, 31(1):CD004720. doi: 10.1002/14651858.CD004720.pub3.Google Scholar
Iyengar, S. (1990), ‘The accessibility bias in politics: television news and public opinion’, International Journal of Public Opinion Research, 2(1):115.10.1093/ijpor/2.1.1CrossRefGoogle Scholar
Lee, V. and Loiselle, C.G (2012), ‘The salience of existential concerns across the cancer control continuum’, Palliat Support Care, 10(2):123–33.CrossRefGoogle ScholarPubMed
Levy, N. (2017), ‘Nudges in a post-truth world’, Journal of Medical Ethics, 43:495500.10.1136/medethics-2017-104153CrossRefGoogle Scholar
Marmot, M.G., Altman, D.G., Cameron, D.A., Dewar, J.A., Thompson, S. G., Wilcox, M. and The Independent UK Panel on Breast Cancer Screening. (2013), ‘The benefits and harms of breast cancer screening: an independent review. A report jointly commissioned by Cancer Research UK and the Department of Health (England) October 2012’, Br J Cancer. 2013 Jun 11; 108(11): 22052240.10.1038/bjc.2013.177CrossRefGoogle Scholar
McGinley, L. The federal panel that opposed prostate cancer screening just changed its mind. The Washington Post. 2017 Apr 11. URL: https://www.washingtonpost.com/news/to-your-health/wp/2017/04/11/the-federal-panel-that-opposed-prostate-cancer-screening-just-changed-its-mind/ (accessed 23 December 2019).Google Scholar
Nelson, H.D., Cantor, A., Humphrey, L., Fu, R., Pappas, M., Daeges, M. and Griffin, J (2016), Screening for Breast Cancer: A Systematic Review to Update the 2009 U.S. Preventive Services Task Force Recommendation. Rockville (MD): Agency for Healthcare Research and Quality (US). Report No.: 14–05201-EF-1.10.7326/M15-0970CrossRefGoogle Scholar
Schwartz, L.M., Woloshin, S., Sox, H.C., Fischhoff, B. and Welch, H.G (2000), ‘US women's attitudes to false positive mammography results and detection of ductal carcinoma in situ: cross sectional survey’, BMJ, 320(7250):1635–40.10.1136/bmj.320.7250.1635CrossRefGoogle ScholarPubMed
Srivastava, S., Koay, E.J., Borowsky, A.D., De Marzo, A.M., Ghosh, S., Wagner, P.D. and Kramer, B.S. (2019), ‘Cancer overdiagnosis: a biological challenge and clinical dilemma’, Nat Rev Cancer. 2019 Jun;19(6):349358.10.1038/s41568-019-0142-8CrossRefGoogle ScholarPubMed
Sunstein, C. Valuing Facebook. Behavioural Public Policy, Feb 2019;1–12. doi:10.1017/bpp.2018.34CrossRefGoogle Scholar
Tran, V.T., Kisseleva-Romanova, E., Rigal, L. and Falcoff, H (2015), ‘Impact of a printed decision aid on patients' intention to undergo prostate cancer screening: a multicentre, pragmatic randomised controlled trial in primary care’, Br J Gen Pract, 65(634):e295304. doi: 10.3399/bjgp15X684817.CrossRefGoogle ScholarPubMed
US Preventive Services Task Force. (2019), Recommendation Statement: Breast Cancer: Screening. URL: https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/breast-cancer-screening1 (accessed 11 08 2019)Google Scholar
Waller, J., Douglas, E., Whitaker, K.L. and Wardle, J (2013), ‘Women's responses to information about overdiagnosis in the UK breast cancer screening programme: a qualitative study’, BMJ Open, 3:e002703. doi: 10.1136/bmjopen-2013–002703CrossRefGoogle ScholarPubMed
Waller, J., Osborne, K. and Wardle, J (2015), ‘Enthusiasm for cancer screening in Great Britain: a general population survey’, Br J Cancer, 112(3): 562566.10.1038/bjc.2014.643CrossRefGoogle ScholarPubMed
Weir-Hughes, D. (2005), ‘Cancer doesn't discriminate: neither should we’, Diversity and Equality in Health and Care, 2: 165.Google Scholar
Woloshin, S. and Schwartz, L.M (2012), ‘How a charity oversells mammography’, BMJ, 345: e5132.10.1136/bmj.e5132CrossRefGoogle ScholarPubMed
World Health Organization. (2014), WHO position paper on mammography screening. World Health Organization. Geneva, Switzerland.Google Scholar