Does the frame affect the picture? A study into how attitudes to screening for cancer are affected by the way benefits are expressed

Abstract

Objective To find out how presenting information about the benefits of screening for cancer in different ways affects an individual's decision to accept or reject screening. Methods A telephone survey of the Wellington region, New Zealand was carried out. Results A response rate of 75.6% was obtained. Respondents were most likely to accept screening when the benefits of screening were presented as a relative risk reduction. They were most likely to reject screening when the benefits were presented as numbers needed to screen to save one life. Conclusions An individual's decision about screening for cancer is affected by the way the benefits are framed. Health professionals must choose between framing the benefits of screening in the most positive light, to enhance participation rates, and presenting information in such a way as to reduce framing effects—for example, by expressing the benefits in a variety of forms. Clearly there may be a tension between these approaches; the former is arguably manipulation, and the latter may enhance informed choice, but may also reduce participation rates in screening programmes.