Review Indicates Colorectal Cancer Screening Guidelines Have Inadequate Reporting and Discussion of Screening Harms

Cancer screening can lead to patient-level harms from screening tests, diagnostic follow-up, and cancer treatment. This review examined U.S. screening guidelines on breast, cervical, colorectal, lung, and prostate cancer for whether they each at least mentioned patient-level harms and whether any discussion of harms was conceptual, qualitative, or quantitative. 

For overall performance, the review rated the guidelines for breast and prostate cancer as the best regarding discussion of harms, and these guidelines were particularly good with discussion of cancer treatment harms and “overarching harms,” including overdiagnosis, financial costs, and psychological effects. Treatment-related harms and overarching harms were areas of relative weakness for colorectal cancer (CRC) screening guidelines. CRC screening guidelines did better with discussion of the harms of the screening process itself and the harms of diagnostic testing (colonoscopy).