Public Knowledge of Benefits of Breast and Prostate Cancer Screening in Europe

Abstract

Making informed decisions about breast and prostate cancer screening requires knowledge of its benefits. However, country-specific information on public knowledge of the benefits of screening is lacking. Face-to-face computer-assisted personal interviews were conducted with 10 228 persons selected by a representative quota method in nine European countries (Austria, France, Germany, Italy, the Netherlands, Poland, Russia, Spain, and the United Kingdom) to assess perceptions of cancer-specific mortality reduction associated with mammography and prostate-specific antigen (PSA) screening. Participants were also queried on the extent to which they consulted 14 different sources of health information. Correlation coefficients between frequency of use of particular sources and the accuracy of estimates of screening benefit were calculated. Ninety-two percent of women overestimated the mortality reduction from mammography screening by at least one order of magnitude or reported that they did not know. Eighty-nine percent of men overestimated the benefits of PSA screening by a similar extent or did not know. Women and men aged 50–69 years, and thus targeted by screening programs, were not substantially better informed about the benefits of mammography and PSA screening, respectively, than men and women overall. Frequent consulting of physicians (r = .07, 95% confidence interval [CI] = 0.05 to 0.09) and health pamphlets (r = .06, 95% CI = 0.04 to 0.08) tended to increase rather than reduce overestimation. The vast majority of citizens in nine European countries systematically overestimate the benefits of mammography and PSA screening. In the countries investigated, physicians and other information sources appear to have little impact on improving citizens’ perceptions of these benefits.

Decisional outcomes following use of an interactive web-based decision aid for prostate cancer screening

“…While screening recommendations vary somewhat by professional organization [5][6][7], the U.S. Preventive Services Task Force now recommends against routine screening for all ages [8]. In the midst of this debate, most men undergoing PCa screening are aware of the benefits, but fewer are aware of the limitations [9,10].…”

Improving Evidence-Based Practices Through Health Literacy—Reply

“…To the Editor The Obesity Society, of which I am the president, is concerned with Woloshin and Schwartz's dismissal of obesity as a disease, disregard for the well-established benefits of modest weight loss, and focus on cardiovascular risk as the sole reason to treat obesity. 1…”

“…For men and PSA screening, this number was 89%. 1 If it were not for the Russians, who had the most realistic estimates among the Europeans, these numbers would be even closer to 100%. Among 160 German gynecologists, 80% did not understand the positive predictive value of a positive mammogram, with estimates varying between 1% and 90%.…”

Neither as harmful as feared by critics nor as empowering as promised by providers: risk information offered direct to consumer by personal genomics companies

“…A face-to-face computer-assisted interview study was conducted with more than 10,000 informants in nine European countries, aiming at assessing perceptions among the general public of cancer-specific mortality reduction associated with mammography and prostate-specific antigen screening. It was found that the vast majority of citizens in these countries systematically overestimate the benefits of screening (Gigerenzer et al 2009). 4.…”

“…the pro arguments for testing analysed above). Gigerenzer's studies of the general public and doctors indicate that risk can easily be misunderstood (Gigerenzer et al 2009;Wegwart and Gigerenzer 2011). Above I briefly presented the risk information that can be found on the websites.…”