Communicating about screening

People are offered a wide range of screening tests by diverse providers. For example: maternal and child health services screen for genetic conditions and developmental problems; general practitioners screen for cardiovascular risk factors; NHS programmes screen for bowel, breast, and cervical cancer; and commercial providers offer various health assessments, including body and gene scans. Provision of tests is not well regulated, and there is a bewildering amount of information of variable accuracy in the public domain.1

It is unclear how healthcare providers should communicate about screening in order to support appropriate uptake. And what constitutes appropriate uptake is also contested because of disagreements about the merits of particular tests and tensions between concerns to promote health and to respect autonomy.2 3 4 Debates about communication have tended to consider two types of approach, which we call “be screened’ and “analyse and choose.” We consider their problems and propose a third approach, “consider an offer.”