[Balancing benefits and harms of population-based interventions, using the example of cancer screening]

Abstract

The assessment of the balance between benefits and harms of population-based interventions faces both methodological and practical difficulties. This paper uses the example of cancer screening to outline existing challenges such as the consideration of outcomes that occur at substantially different times, or the lack of direct evidence which can lead to false conclusions and adverse health effects for healthy individuals undergoing screening. Sometimes not even sound evidence provides clear answers about the benefits and harms of preventive interventions. This is why informed decision-making is a particularly important step for individuals taking preventive interventions into consideration. Due to the lack of a clear answer to the question of benefits and harms from scientific evidence, individuals' attitudes and values may become a decisive factor. Studies, however, indicate that the prerequisite for informed decision making, namely objective and balanced information about benefits and harms, is often missing.