Evidence map›Paper›PMID 33268404›Full record

ArticleBMJ open2020

How do cancer screening guidelines trade off benefits versus harms and burdens of screening? A systematic survey.

Linan Zeng, Lise Mørkved Helsingen, Fernando Kenji Nampo, Yuting Wang, Liang Yao, Reed Alexander Siemieniuk, Michael Bretthauer, Gordon H Guyatt

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Esophageal cancer: Epidemiology, risk factors and screening.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2021
    Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Linan ZengPharmacy Department/Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University; Key Laboratory of Birth Defects and Related Disease of Women and Children (Sichuan University), Ministry of Education, Chengdu, China zengl15@mcmaster.ca.
Lise Mørkved HelsingenClinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, and Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.ORCID 0000-0002-2055-3978
Fernando Kenji NampoLatin-American Institute of Life and Nature Sciences/Evidence-Based Public Health Research Group, Federal University of Latin-American Integration, Foz do Iguacu, Paraná, Brazil.
Yuting WangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Liang YaoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Reed Alexander SiemieniukDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-3725-3031
Michael BretthauerClinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, and Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Gordon H GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesCancer screening guidelines differ in their recommendations for or against screening. To be able to provide explicit recommendations, guidelines need to specify thresholds for the magnitude of benefits of screening, given its harms and burdens. We evaluated how current cancer screening guidelines address the relative importance of benefits versus harms and burdens of screening. DATA SOURCE: We searched the Guidelines International Network, International Guideline Library, ECRI Institute and Medline. Two pairs of reviewers independently performed guideline selection and data abstraction. ELIGIBILITY CRITERIA: We included all cancer screening guidelines published in English between January 2014 and April 2019.

resultsOf 68 eligible guidelines, 25 included a statement regarding the trade-off between screening benefits versus harms and burdens (14 guidelines), or a statement of direction of the net effect (defined as benefits minus harms or burdens) (13 guidelines). None of these 25 guidelines defined how large a screening benefit should be to recommend screening, given its harms and burdens. 11 guidelines performed an economic evaluation of screening. Of these, six identified a key benefit outcome; two specified a cost-effectiveness threshold for recommending a screening option. Eight guidelines commented on people's values and preferences regarding the trade-off between benefits versus harms and burdens.

conclusionsCurrent cancer screening guidelines fail to specify the values and preferences underlying their recommendations. No guidelines provide a threshold at which they believe the benefits of screening outweigh its harms and burdens. PROSPERO REGISTRATION NUMBER: CRD42019138590.

Indexed as

Early Detection of CancerNeoplasmsCost-Benefit AnalysisHumansMass ScreeningSurveys and Questionnaireshealth policyprotocols & guidelinesquality in health care

Identifiers

PMID33268404
PMCPMC7713181

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.