Communicating the benefits and harms of colorectal cancer screening needed for an informed choice: a systematic evaluation of leaflets and booklets

PLoS One. 2014 Sep 12;9(9):e107575. doi: 10.1371/journal.pone.0107575. eCollection 2014.


Objective: Evidence-based health information (EBHI) can support informed choice regarding whether or not to attend colorectal cancer (CRC) screening. The present study aimed to assess if German leaflets and booklets appropriately inform consumers on the benefits and harms of CRC screening.

Methods: A systematic search for print media on CRC screening was performed via email enquiry and internet search. The identified documents were assessed for the presence and correctness of information on benefits and harms by two reviewers independently using a comprehensive list of criteria.

Results: Many of the 28 leaflets and 13 booklets identified presented unbalanced information on the benefits and harms of CRC screening: one-third did not provide any information on harms. Numeracy information was often lacking. Ten cross-language examples of common misinterpretations or basically false and misleading information were identified.

Discussion: Most of the CRC screening leaflets and booklets in Germany do not meet current EBHI standards. After the study, the publishers of the information materials were provided feedback, including a discussion of our findings. The results can be used to revise existing information materials or to develop new materials that provide correct, balanced, quantified, understandable and unbiased information on CRC screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / psychology
  • Early Detection of Cancer*
  • Germany
  • Health Services Needs and Demand
  • Humans
  • Internet
  • Mass Screening*
  • Publications*

Grant support

This work was supported in part by the German Federal Ministry of Health. Further support came from internal funding sources supplied by the Institute for Epidemiology, Social Medicine and Health System Research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.