Intended for healthcare professionals

CCBYNC Open access

Rapid response to:


Quantifying and monitoring overdiagnosis in cancer screening: a systematic review of methods

BMJ 2015; 350 doi: (Published 07 January 2015) Cite this as: BMJ 2015;350:g7773

Rapid Response:

A systematic review concluded that patients with lower health literacy level were less likely to have cancer screening tests (Oldach & Katz, 2014), which further lead to cancer disparities. If we consider patients’ health literacy as a contributing factor in the cancer screening guidelines, it might help to have clear communication between doctors and patients. To do so, doctors also need to improve communication skills then address health literacy (Green, Gonzaga, Cohen, & Spagnoletti, 2014).

Patients’ health literacy refers to the ability to find, understand, appraise and apply information on health, especially in disease prevention and health promotion. They then make the correct decision on which test, number of tests (sometimes need more than one test), time, technique, and guideline to follow and collaborate well with doctors. Thus, test results will be more precise, and doctors’ decision will be more accurate. Therefore, beside new screening technology, new treatment, and interventions to reduce overdiagnosis, patient’s health literacy together with doctors’ clear communication skills will reduce the rate of overdiagnosis.


Green, J. A., Gonzaga, A. M., Cohen, E. D., & Spagnoletti, C. L. (2014). Addressing health literacy through clear health communication: A training program for internal medicine residents. Patient Education and Counseling, 95(1), 76-82. doi:

Oldach, B. R., & Katz, M. L. (2014). Health literacy and cancer screening: A systematic review. Patient Educ Couns, 94(2), 149-157. doi:

Competing interests: No competing interests

26 January 2015
Van Tuyen Duong
Scientific Researcher
Taipei Medical University
No 250, Wuxing Street, Taipei City, Taiwan, 110