title: ["IGeL" or not: cancer screening always needs comprehensive information].
abstract: BACKGROUND
  Cancer screening tests such as ultrasound scans, extensive skin cancer screening, or the prostate-specific antigen (PSA) test are among the most commonly used individual out-of-pocket health services (in German: Individuelle Gesundheitsleistungen, or IGeL) among people who have statutory health insurance in Germany. They are usually offered as an add-on to the services that are covered by statutory insurers.
  There are a number of reasons why cancer screening tests might not be covered by insurers. The main reasons are because the test does not have any clear benefits, and because the harms outweigh the benefits. This article describes the fundamental difficulties of, and the requirements imposed on, benefit assessments of cancer screening tests.
  
  
  RESULTS
  Cancer screening tests that are available as individual out-of-pocket health services are always potentially harmful, while their benefit is either not clear or contested, or there is clearly no benefit.
  
  
  CONCLUSIONS
  Health-care providers who offer cancer screening tests are required to provide interested people with relevant information on the related benefits, harms, and uncertainties of the tests, so as to enable an informed decision. This is especially important when it comes to "IGeL" services.
authors.affiliation: Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG), Im Mediapark 8, 50670, Köln, Deutschland, klaus.koch@iqwig.de.
authors.forename: K
authors.initials: K
authors.lastname: Koch
authors.forename: S
authors.initials: S
authors.lastname: Thomas
authors.forename: J
authors.initials: J
authors.lastname: Windeler
mesh_terms: D003657:Decision Making; D055088:Early Detection of Cancer / Q000191:economics*; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D007258:Informed Consent; D018570:Risk Assessment / Q000191:economics
vernacular_title: IGeL oder Nicht-IGeL : Krebsfrüherkennung braucht immer eine umfassende Aufklärung.