Ethical issues for cancer screenings - Five countries - four types of cancer

Ustun C. , CEBER E.

PREVENTIVE MEDICINE, vol.39, no.2, pp.223-229, 2004 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 39 Issue: 2
  • Publication Date: 2004
  • Doi Number: 10.1016/j.ypmed.2004.03.020
  • Title of Journal : PREVENTIVE MEDICINE
  • Page Numbers: pp.223-229
  • Keywords: screening programs, medical ethics, cancer, cancer prevention, early detection, COLORECTAL-CANCER, PROSTATE-CANCER, BREAST-CANCER, INFORMED CONSENT, RATIONALE, MAMMOGRAPHY, GUIDELINES, AUTONOMY, PATIENT, UPDATE


In recent years, medical ethics has become an undisputed part of medical studies. Many people believe that modem advances in medical technology-such as the development of dialysis machines, respirators, magnetic resonance imaging, and genetic testing and types of cancer screenings-have created the bioethical dilemmas that confront physicians in the 21st century. Debates over research and screening ethics have until recently revolved around two related questions: the voluntary, informed consent of subjects, and the appropriate relationship between risk and benefit to subjects in the experiment. Every patient has a right to full and accurate information about his or her medical condition. This legal principle arose primarily through court decisions concerning informed consent, but over time, physicians recognized that most patients prefer to learn the truth about their condition and use the information well. To screen is to search for disease in the absence of symptoms or, in other words, to attempt to find disease in someone not thought to have a disease. Examples of screening include routine mammography to detect breast cancer, routine Pap smears to detect cervical cancer and routine prostate specific antigen (PSA) testing to detect prostate cancer. Ethical principles to be followed in cancer screening programs are intended mainly to minimize unnecessary harm to the participating individuals. Numerous ethical questions can be raised about the practice of screening for disease. This paper reviews recommendation for cancer screening from five countries, examine them from an ethical perspective, and make conclusion from this analysis. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.