Cancer screening programs should incorporate values and preferences of potential participants

With great interest, we have read Selva et al.’s [[1]Selva A. Sanabria A.J. Nino de Guzman E. Ballesteros M. Selva C. Valli C. et al.Colorectal cancer guidelines seldom include the patient perspective.J Clin Epidemiol. 2019; 116: 84-97Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar] paper on the need to include the patient perspective in colorectal cancer guidelines. We fully agree with the authors that patient values and preferences are currently insufficiently incorporated in most guidelines, whereas they may be at least as important to individuals as receiving a general, purely medical advice. Moreover, health care professionals should be aware of the impact that expression of their own values and preferences might have on their patients [[2]Knottnerus B.J. Cancer screening is not only about numbers.Eur J Cancer Care. 2017; 26: e12700Crossref Scopus (3) Google Scholar]. As these considerations may also be relevant in the context of screening programs, in our own mixed-methods research on colorectal cancer screening, we investigate values and preferences of persons who underwent a recommended colonoscopy after an abnormal screening test result as well as of persons who did not undergo that colonoscopy. In that context, we are studying the potential impact of factors that might be addressed during (primary care) consultations about colorectal cancer screening but are seldom mentioned in guidelines, such as risk perception, uncertainty, fears, and social circumstances. More in general, in line with the conclusions of Selva et al., we believe that it is important to routinely include screening invitees’ values and preferences and their impact in the development and evaluation of cancer screening programs, in order to provide more evidence support for (potential) screening participants and their medical advisers, in primary care and beyond.