The prevention paradox is a problem that occurs, when medical interventions have to be performed on a lot of people and only a small number of them perceives or receives benefits. Still the effects on public health are remarkable. This problem leads to a low acceptancy of these interventions.
Example: Screening for colorectal cancer: Colonoscopy in Germany
“The average annual participation rate for the age range examined was 2.6% of those entitled to screening colonoscopies.“
“An estimated total number of 98 734 cases of colorectal cancer at ages 55–84 years are expected to have been prevented in Germany by removal of advanced adenomas by the end of 2010. These cancers might have become clinically manifest a median time period of 10 years after screening colonoscopy. Another 47 168 cases are expected to have been detected early at screening colonoscopy, often in a curable stage.“
(“Eight Years of Colonoscopic Bowel Cancer Screening in Germany. Initial Findings and Projections.”, Brenner H, Altenhofen L, Hoffmeister M., Dtsch. Arztebl. Int. 2010 October; 107(43): 753–759. )
Example: Vaccination of measels in Germany
Measels are preventable by vaccination. Two vaccinations during childhood are recommended. In Germany there are still thousands of children who do not get vaccinated for different reasons. Major outbreaks include cases in 2005 in Hessen (one patient died), the 2006 outbreak in Nordrhein-Westfalen (1700 cases, 2 children died, one child suffers from SSPE, a condition that is always live-threatening) and 2010 at a Waldorf school in Essen (71 cases, 4 patients hospitalized)
Vaccination rates in 2010 are between 85% and 94%
( http://www.rki.de/cln_160/nn_494538/DE/Content/Service/Presse/Pressemitteilungen/2010/06__2010.html)
These examples show, that new strategies are necessary to communicate preventive medical procedures.
–Johannes Heymer