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Editorial |

Informed Choice in Cancer Screening

H. Gilbert Welch, MD, MPH
JAMA. 2001;285(21):2776-2778. doi:10.1001/jama.285.21.2776.
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I've always known shared decision making involves real work, but recently the challenge really hit home. A few days after I was invited to write this editorial, I visited my 80-year-old mother in Colorado. (Note: this is pure coincidence, both events are rare. . . . ) She had just learned that she had carotid artery stenosis. She was asymptomatic and was being asked to consider angiography and possibly surgery. Her physician and I wanted her to make an informed choice. She asked me to write the relevant information on a single sheet of paper, so she could read it, think about it, and read it again. I struggled with the assignment. The primary data source was clear: the ACAS (Asymptomatic Carotid Atherosclerosis Study)1 and the mortality rate observed in the real world.2

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