Summary: This week: The complex set of components involved in the decision to screen (or not) for colon cancer includes input from both the doctor (e.g., data about what might happen and how likely the possibilities are) and the patient (e.g., how the patient weighs the relative desirability of the various possible outcomes that result from the possible decisions). Embedded in experts' recommendations for colorectal cancer screening are nearly impossible demands on primary care clinicians to discuss the pros and cons of various modalities for screening with each patient and to assess risk even to the detail of learning the pathology of the biopsy of relatives' colonoscopies (e.g., adenomatous vs. hyperplastic polyps).
