Limits...
Women's participation in breast cancer screening in France--an ethical approach.

Moutel G, Duchange N, Darquy S, de Montgolfier S, Papin-Lefebvre F, Jullian O, Viguier J, Sancho-Garnier H, GRED French National Cancer Institu - BMC Med Ethics (2014)

Bottom Line: The low coverage of the OS scheme may be partly explained by the fact that a significant number of women undergo mammography outside OS and thus outside OS criteria.We advocate a move to integrate the points sparking debate over the efficiency of the screening scheme to guarantee full transparency.The perspective is to strengthen the respect for autonomy allowing women to make an informed choice in their decision on whether or not to participate.

View Article: PubMed Central - HTML - PubMed

Affiliation: Assistance Publique Hôpitaux de Paris, Hôpital Universitaire Georges Pompidou Corentin-Celton, Université Paris Descartes, 92130 Issy-les-Moulineaux, France. gregoire.moutel@parisdescartes.fr.

ABSTRACT

Background: Breast cancer is a major public health challenge. Organized mammography screening (OS) is considered one way to reduce breast cancer mortality. EU recommendations prone mass deployment of OS, and back in 2004, France introduced a national OS programme for women aged 50-74 years. However, in 2012, participation rate was still just 52.7%, well short of the targeted 70% objective. In an effort to re-address the (in) efficiency of the programme, the French National Cancer Institute has drafted an expert-group review of the ethical issues surrounding breast cancer mammography screening.

Discussion: Prompted by emerging debate over the efficiency of the screening scheme and its allied public information provision, we keynote the experts' report based on analysis of epidemiological data and participation rate from the public health authorities. The low coverage of the OS scheme may be partly explained by the fact that a significant number of women undergo mammography outside OS and thus outside OS criteria. These findings call for further thinking on (i) the ethical principles of beneficence and non-malfeasance underpinning this public health initiative, (ii) the reasons behind women's and professionals' behavior, and (iii) the need to analyze how information provision to women and the doctor-patient relationship need to evolve in response to scientific controversy over the risks and benefits of conducting mammographic screening.

Summary: This work calls for a reappraisal of the provision of screening programme information. We advocate a move to integrate the points sparking debate over the efficiency of the screening scheme to guarantee full transparency. The perspective is to strengthen the respect for autonomy allowing women to make an informed choice in their decision on whether or not to participate.

No MeSH data available.


Related in: MedlinePlus

Evolution of mortality and incidence rates (1/100,000) in France from 1980 to 2012[3,4].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4151080&req=5

Figure 1: Evolution of mortality and incidence rates (1/100,000) in France from 1980 to 2012[3,4].

Mentions: Breast cancer is a major public health challenge. It is the most common cancer among women in France, accounting for an estimated 48,763 new cases and 11,886 deaths in 2012[3]. According to French National Institute of Statistics and Economic Studies (INSEE), breast cancer incidence increased 1.4% per year over the 1980–2012 period (Figure 1)[3,4].


Women's participation in breast cancer screening in France--an ethical approach.

Moutel G, Duchange N, Darquy S, de Montgolfier S, Papin-Lefebvre F, Jullian O, Viguier J, Sancho-Garnier H, GRED French National Cancer Institu - BMC Med Ethics (2014)

Evolution of mortality and incidence rates (1/100,000) in France from 1980 to 2012[3,4].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4151080&req=5

Figure 1: Evolution of mortality and incidence rates (1/100,000) in France from 1980 to 2012[3,4].
Mentions: Breast cancer is a major public health challenge. It is the most common cancer among women in France, accounting for an estimated 48,763 new cases and 11,886 deaths in 2012[3]. According to French National Institute of Statistics and Economic Studies (INSEE), breast cancer incidence increased 1.4% per year over the 1980–2012 period (Figure 1)[3,4].

Bottom Line: The low coverage of the OS scheme may be partly explained by the fact that a significant number of women undergo mammography outside OS and thus outside OS criteria.We advocate a move to integrate the points sparking debate over the efficiency of the screening scheme to guarantee full transparency.The perspective is to strengthen the respect for autonomy allowing women to make an informed choice in their decision on whether or not to participate.

View Article: PubMed Central - HTML - PubMed

Affiliation: Assistance Publique Hôpitaux de Paris, Hôpital Universitaire Georges Pompidou Corentin-Celton, Université Paris Descartes, 92130 Issy-les-Moulineaux, France. gregoire.moutel@parisdescartes.fr.

ABSTRACT

Background: Breast cancer is a major public health challenge. Organized mammography screening (OS) is considered one way to reduce breast cancer mortality. EU recommendations prone mass deployment of OS, and back in 2004, France introduced a national OS programme for women aged 50-74 years. However, in 2012, participation rate was still just 52.7%, well short of the targeted 70% objective. In an effort to re-address the (in) efficiency of the programme, the French National Cancer Institute has drafted an expert-group review of the ethical issues surrounding breast cancer mammography screening.

Discussion: Prompted by emerging debate over the efficiency of the screening scheme and its allied public information provision, we keynote the experts' report based on analysis of epidemiological data and participation rate from the public health authorities. The low coverage of the OS scheme may be partly explained by the fact that a significant number of women undergo mammography outside OS and thus outside OS criteria. These findings call for further thinking on (i) the ethical principles of beneficence and non-malfeasance underpinning this public health initiative, (ii) the reasons behind women's and professionals' behavior, and (iii) the need to analyze how information provision to women and the doctor-patient relationship need to evolve in response to scientific controversy over the risks and benefits of conducting mammographic screening.

Summary: This work calls for a reappraisal of the provision of screening programme information. We advocate a move to integrate the points sparking debate over the efficiency of the screening scheme to guarantee full transparency. The perspective is to strengthen the respect for autonomy allowing women to make an informed choice in their decision on whether or not to participate.

No MeSH data available.


Related in: MedlinePlus