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Not all cancer screening tests seem to make sense. Shouldn’t people be receiving better information so they can make their own decisions?



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Photo: Astrid Blank

In Germany, 43 million cancer screening tests are carried out every year. This policy is supported and encouraged by the government as it is commonly thought that an early diagnosis will lead to better treatment, increased life expectancy, and improved quality of life. But is that really always the case?
Screening methods are becoming more and more effective; even precancerous lesions can now be identified. But not all screening tests necessarily lead to increased life expectancy. And it is becoming increasingly clear that not every cancer is fatal, and may not actually affect a patient’s quality of life. What is needed, then, is a screening method capable of distinguishing lethal forms of cancer from those that do not put a patient’s life at risk. Extensive research is being carried out in this area.
As things stand, everyone has to decide for themselves whether they think a particular screening test would do them more harm than good. As soon as the dreaded diagnosis of “cancer” has been made, fear sets in, and follow-up examinations are carried out that can sometimes be painful. There is also a risk of false-positive test results potentially leading to unnecessary treatments.
Prof. Gerd Gigerenzer, director of the Harding Center for Risk Literacy at the Max Planck Institute for Human Development, has been campaigning for years to improve risk literacy education, and the ability to better understand statistics. For him, it is essential for people to become more skilled at assessing the risks of everyday life in order to be able to deal with uncertainties. This is particularly important when it comes to health, since many people go to cancer screening tests with false expectations, or interpret their results incorrectly. Doctors and journalists also need to be able to interpret risks accurately and to provide clear, reliable information to patients and the general public.
At the Harding Center, doctors, journalists and patient organisations are trained in dealing with risks. Clear and accessible information on various methods for early detection is also available on the centre’s website at

Dr Susann Beetz of the Ideas 2020 team answered this question with the support of Ines Lein of the Harding Center for Risk Literacy at the Max Planck Institute for Human Development.