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Views And Reviews

Cancer screening review diminishes informed choice

BMJ 2019; 367 doi: (Published 31 October 2019) Cite this as: BMJ 2019;367:l6224
  1. Margaret McCartney, GP partner
  1. Glasgow, UK
  1. mgtmmccartney{at} 

We should resist the push for financial incentives, increased screening uptake, reorganisation, and restructuring, says Margaret McCartney

Mike Richards’s independent review of adult screening programmes in England is out and can be summarised as “nothing is too much.”1 Calling for financial incentives, increased uptake, reorganisation, and restructuring, Richards writes, “Every day of delay is a missed opportunity to catch a person’s cancer or disease at an earlier point, and potentially save their life.”

Healthcare in the UK is a shifting entanglement of policies and politics, frequently at odds with each other. Initiatives launched with aplomb are quietly reversed later. We get soundbites, not substance, and, crucially, little chance to permanently embed learning and improve the way evidence and policy meet. The past decade saw acknowledgment of overdiagnosis and the ethical need for choice in screening. This report waves that off. It misunderstands what screening is, and what it can and cannot do.

Firstly, there’s …

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