In the next section, I will briefly discuss the principle barriers to the effective transmission of information related to cancer. These barriers apply as well to the conveyance of information regarding genetic predisposition to cancer, genetic testing, and screening mammography. The decisions at hand are frequently very complex and the terminology quite unfamiliar to people. Few women can approach such a decision with any prior familiarity of the underlying issues or treatment options. Much of the information which must be taken into consideration for informed decision making is highly numerical in nature.
Most people are uncomfortable with statistical terms and unfamiliar with probabilistic thinking.
Results from a study by Dr. William Black and colleagues at Dartmouth suggest that a limited working knowledge of probability estimates worsens an already poor understanding of the potential benefit of screening mammography among women between 40 and 50 years of age. This problem is further compounded by frequent disregard on the part of information providers of the important difference between absolute and relative benefit. Even when the difference between absolute and relative benefit are understood, many people find it difficult to translate statistics of a group to the reality of an individual. Cognitive psychologists have long recognized that one's ability to assimilate complex information is impaired when there is a strong emotional component. Time constraints, on both the health-care provider and the patient, are an unavoidable challenge.