Do Physicians Understand Cancer Screening Statistics? A National Survey of Primary Care Physicians in the United States

Abstract

Background: Unlike reduced mortality rates, improved survival rates and increased early detection do not prove that cancer screening tests save lives. Nevertheless, these 2 statistics are often used to promote screening.

Emergency Physician Perceptions of Shared Decision‐making

“…Some have proposed that in preference-sensitive decisions, patients need exact probabilities of harms and benefits associated with each option to appropriately weigh the pros and cons of each; 6 however, these probabilities are often not available in EM, and even when they are, both patients and physicians may be limited by the inherent challenges of effective risk communication. [10][11][12][13][14] Finally, patients who are potentially critically ill may prefer that clinicians take a more dominant role in decision-making. [15][16][17][18] Despite nationwide efforts and focus on patient-centeredness, viewpoints of frontline practicing clinicians on how practically to achieve increased patient engagement remain largely unknown.…”

Improving Evidence-Based Practices Through Health Literacy—Reply

“…3 The dismissive tone of the article by Woloshin and Schwartz 1 is in contrast to another recent article on drug treatment of obesity, which noted that the new drugs may be useful adjuncts to lifestyle treatment for carefully selected patients. 4 Bias against people with obesity, even from physicians, is well documented.…”

“…Studies have shown that even those who have high fundamental literacy skills have poor health literacy and that up to half of US adults are not able to effectively use written material to accomplish healthrelated tasks. 3 The practice of medicine is dynamic with constant shifts to diagnostic and treatment paradigms. The exponential growth of medical knowledge adds to the complexity of medical care, and there is the concern that physicians have difficulties accurately interpreting and translating evidence into clinical practice.…”

“…2 Among a national sample of 412 US primary care physicians, 47% wrongly thought that if more cancers are detected by a screening test, this proves that the test saves lives, and 76% mistakenly believed that if screendetected cancers have better 5-year-survival rates than cancers detected by symptoms, this would prove that a screening test saves lives. 3 Why do we have this lack of risk literacy in health care? One frequently discussed answer assumes that people are troubled with cognitive deficits that make them predictably irrational and basically hopeless at dealing with risks so that they need to be "nudged" into healthy behavior.…”

“…Yet, science clearly demonstrates that this magnitude of weight loss improves diabetes, physical functioning, pain, and quality of life. 3 A singular focus on using obesity drugs to reduce cardiovascular events misses the numerous important benefits of treating obesity on overall health.…”