Ethical issues with colorectal cancer screening—a systematic review

Abstract

A series of important ethical issues have been identified and need to be addressed in open and transparent deliberation on CRC screening.

Nudging in screening: Literature review and ethical guidance

“…Nudging is also debated in areas such as screening for abdominal aorta aneurisms [14], obesity [30][31][32][33], diabetes [34,35], chronic beryllium disease [36], and HIV [21,[37][38][39]. However, the majority of references are to various types of cancer screening [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58], predominantly breast cancer screening [2,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75].…”

“…Minor monetary incentives [89], appeals to fear, and the use of threats have also been discussed [90]. Moreover, the mere offering of a screening program is interpreted as a recommendation by the public and may also be viewed as nudging [45,65]. In this context, appealing to people's sense of responsibility, solidarity, and duty have been pointed out to be mechanisms by which to increase attendance.…”

Det store tarmkreftlotteriet

“…Det er ingen tvil om at nasjonale screeningprogrammer er en ypperlig måte å finansiere forskning på (3), men forslaget om å blande forskning og helsetjeneste reiser metodiske og etiske spørsmål (7,8). Det baserer seg på korrekt diagnose: Vi har begrenset kunnskap om metodene for tarmkreftscreening.…”

Psychometric properties of the SCREESCO questionnaire used in a colorectal cancer screening programme—A Rasch analysis

“…The movement within the health care sector towards a more participatory perspective, where individual preferences and autonomy are taken into account, has led to the increased importance of shared decision making (SDM) and is suggestively applied when deciding upon cancer screening participation . In screening programs, where healthy individuals are approached, it is vital to ensure the autonomy of participants . Therefore, it is desired that individuals make an informed decision, whether it is to participate or not, on knowledge rather than ignorance, misconceptions, or fear.…”

“…8 In screening programs, where healthy individuals are approached, it is vital to ensure the autonomy of participants. 9 Therefore, it is desired that individuals make an informed decision, whether it is to participate or not, on knowledge rather than ignorance, misconceptions, or fear. The Informed Medical Decisions Foundation describes SDM as a process that makes it possible for individuals and health care providers to make decisions about health care issues together.…”