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Breast cancer screening controversy

too much or not enough?

Pivot, Xaviera; Viguier, Jérômeb; Touboul, Chantalc; Morère, Jean-Françoisd; Blay, Jean-Yvese; Coscas, Yvanf; Lhomel, Christineg; Eisinger, Françoish,i,j

European Journal of Cancer Prevention: July 2015 - Volume 24 - Issue - p S73–S76
doi: 10.1097/CEJ.0000000000000145
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The Cochrane analysis exploring the risk/benefit ratio of breast cancer screening resulted in a controversy worldwide spread by the mass media. Our survey sought to assess the impact of this controversy in terms of breast cancer screening awareness and attendance. A nationwide observational study, recorded in the EDIFICE iterative surveys, with a representative sample of 451 women aged 40–75 years, living in France, was carried out in the 3 months after the start of the controversy in January 2013. Of the 405 women with no personal history of cancer, 69 (17%) declared having heard of the controversy (aware group). Women remembering the controversy were more likely to belong to higher socioprofessional categories and to have a higher level of education. The most frequently remembered issues were overdiagnosis (38%), unreliability (16%) and radiation risk (9%). Compared with women who were unaware of the controversy, the aware group knew more about the limits of breast cancer screening (undiagnosed cancers, 20 vs. 7%, P<0.05 and risk of false positives, 20 vs. 2%, P<0. 05) and were more likely to change their opinion for the worse over the mass media debate (8.7 vs. 1.2%, P<0.05). Nevertheless, only 1% of the aware-group declared their intention to subsequently undergo screening less frequently. The low impact of the controversy on the behaviour of women with respect to screening suggests that it should not be seen as a threat to screening attendance rates, but more as an opportunity to improve awareness.

aDepartment of Medical Oncology, Jean Minjoz University Hospital, Inserm U645, Besançon

bCoordination Center for Cancer Screening, Bretonneau University Hospital, Tours

cKantar Health, Montrouge

dDepartment of Oncology and Hematology, Paul-Brousse University Hospital, Inserm U1004, Villejuif

eLéon Bérard Cancer Centre, Lyon

fPorte de Saint-Cloud Clinic, Boulogne-Billancourt

gRoche, Boulogne-Billancourt

hCancer Control Department, Paoli-Calmettes Institute

iAix Marseille University, UMR_S912, IRD

jINSERM, UMR912 (SESSTIM), Marseille, France

Correspondence to Xavier Pivot, MD, PhD, Department of Medical Oncology, Jean Minjoz University Hospital, 3 Boulevard Alexandre Fleming, 25030 Besançon, France Tel: +33 381 66 86 93; fax: +33 381 66 88 08; e-mail: xavier.pivot@univ-fcomte.fr

Received February 16, 2015

Accepted February 18, 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.