Ronald N. Adler

Dr. Adler is Associate Professor of Family Medicine and Community Health at the University of Massachusetts Medical School. He has lectured internationally on the challenges associated with cancer screening. These include the facts that for many people, cancer screening is more likely to cause harm than benefit, yet there are important potential benefits of cancer screening that are still worth pursuing. This can make decisions about cancer screening difficult, for there are always trade-offs to consider. Though early detection may sometimes produce better outcomes, harms such as false positive test results and the overdiagnosis and treatment of indolent cancers are often more likely.

Dr. Adler recommends a patient-centered, evidence-based approach to cancer screening in which health care providers help patients make the best decisions for them as individuals -- decisions that are informed by the best available evidence and the personal values and preferences of each patient.

Frustrated by a lack of good resources to help clinicians and patients have these conversations, Dr. Adler created this book, which is designed to fill that gap. The book illustrates anticipated benefits and harms -- and their relative likelihood -- in ways that are readily understood by patients regardless of literacy level. It can be used independently by patients or under the guidance of a member of the health care team in ways that can make practice workflow more efficient.

Colorful analogies (TURTLES, BEARS, and GRENADES) help patients -- and health care providers -- appreciate the heterogeneity of cancer, which is essential for understanding the trade-offs that lurk behind cancer screening decisions.