A recent systematic survey published in BMJ Open evaluated how current cancer screening guidelines addressed the benefits versus harms and burdens attributed to screening. Cancer guidelines from high-income and upper-middle-income countries from North America, Europe, Central Asia, East Asia, the Pacific, Latin America, the Caribbean, the Middle East, and North Africa were included. Multiple guidelines for breast, colorectal, cervical, prostate, lung, ovarian, and thyroid cancers and a single guideline from 9 other cancers were included in the study.

The study found that cancer screening guidelines reviewed failed to address the issue of cost/benefit in their recommendations (although cost/benefit was likely considered when the guidelines were developed). Additionally, the study found that none of the 68 guidelines reviewed provided a threshold for when the benefits of cancer screening outweigh the associated harms and burdens. The findings of this study apply to medicine today as a shift from paternal medical care to patient-centered care is taking place. Including a discussion on benefits and harms in cancer screening guidelines would offer patients more complete information to consider when deciding whether or not to undergo cancer screening.

Zeng L, et al. BMJ Open 2020;10:e038322. doi:10.1136/bmjopen-2020-038322

cancer screening cost benefit not in recommendations