基于人口的癌症筛查计划正从年龄和/或性别为基础的筛查标准转向风险分层方法。任何这样的变化都必须得到公众认可并有效传达。我们的目标是探讨在结肠癌筛查计划的三个不同阶段实施风险分层的社会和伦理考虑，并了解公众对沟通的要求。我们进行了两组社区陪审团，讨论了筛查资格的风险分层或转介结肠镜检查的阈值和筛查间隔。在了解了筛查原则、伦理考虑和如何将风险分层纳入其中的一系列演示和讨论后，参与者对研究问题进行了深入探讨。然后，他们就风险分层筛查的可接受性以及有关首选筛查策略的信息应该分享什么进行了最终裁决。采用编码主题分析方法对记录进行了分析。风险分层肠癌筛查得到了知情公众的认可。利用当前系统中的数据（年龄、性别和筛查结果）被认为是下一步的明显选择，收集有关生活方式和/或遗传风险评估的附加数据也优于以年龄为基础的筛查。参与者承认个体和卫生服务的好处，并提出了对低癌症风险人群、公众误解和系统的附加复杂性的关切。强调了有关筛查计划变化和个体风险反馈的清晰和有效的沟通的需求，包括在默认情况下与每个人分享的信息与其他地方提供的额外细节之间的区别。从公众可接受性的角度来看，可以立即实施使用当前数据的风险分层，超过更复杂的策略。收集有关生活方式和/或遗传风险评估的附加数据也被认为是可接受的，但需要仔细考虑收集此类数据的实际情况以及如何传达该计划。©2023年 BioMed Central Ltd.，施普林格自然出版集团的一部分。

Population-based cancer screening programmes are shifting away from age and/or sex-based screening criteria towards a risk-stratified approach. Any such changes must be acceptable to the public and communicated effectively. We aimed to explore the social and ethical considerations of implementing risk stratification at three different stages of the bowel cancer screening programme and to understand public requirements for communication.We conducted two pairs of community juries, addressing risk stratification for screening eligibility or thresholds for referral to colonoscopy and screening interval. Using screening test results (where applicable), and lifestyle and genetic risk scores were suggested as potential stratification strategies. After being informed about the topic through a series of presentations and discussions including screening principles, ethical considerations and how risk stratification could be incorporated, participants deliberated over the research questions. They then reported their final verdicts on the acceptability of risk-stratified screening and what information should be shared about their preferred screening strategy. Transcripts were analysed using codebook thematic analysis.Risk stratification of bowel cancer screening was acceptable to the informed public. Using data within the current system (age, sex and screening results) was considered an obvious next step and collecting additional data for lifestyle and/or genetic risk assessment was also preferable to age-based screening. Participants acknowledged benefits to individuals and health services, as well as articulating concerns for people with low cancer risk, potential public misconceptions and additional complexity for the system. The need for clear and effective communication about changes to the screening programme and individual risk feedback was highlighted, including making a distinction between information that should be shared with everyone by default and additional details that are available elsewhere.From the perspective of public acceptability, risk stratification using current data could be implemented immediately, ahead of more complex strategies. Collecting additional data for lifestyle and/or genetic risk assessment was also considered acceptable but the practicalities of collecting such data and how the programme would be communicated require careful consideration.© 2023. BioMed Central Ltd., part of Springer Nature.