BMJ 1997;314:1762 (14 June)

Letters

Informed participation in screening is essential

Editor–A paradox with early detection is that its popularity bears little relation to the magnitude of its benefits and harms. Sarah Stewart-Brown and Andrew Farmer's editorial about screening could therefore be dismissed by some people as public health negativism.1 There is sparse evidence that subjects suffer psychological morbidity, so why worry?

Consider what happens when we screen 250 000 women for cervical cancer. The aim is to help a subset of the 40 or so women who would die annually of cervical cancer among this number. It can only be a subset because not all cases are detectable through screening, and not all those detected are amenable to cure even if found early. Among those patients tested we find newly abnormal smears in some 15 500.2 All but a few hundred (that is, the number of incident serious cases during a screening round of five years) represent overdetection. In other . . . [Full text of this article]


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Relevant Article

Screening could seriously damage your health
Sarah Stewart-Brown and Andrew Farmer
BMJ 1997 314: 533. [Extract] [Full Text]

This article has been cited by other articles:

  • Mathieu, E., Barratt, A., Davey, H. M., McGeechan, K., Howard, K., Houssami, N. (2007). Informed Choice in Mammography Screening: A Randomized Trial of a Decision Aid for 70-Year-Old Women. Arch Intern Med 167: 2039-2046 [Abstract] [Full text]  
  • Jepson, R G, Hewison, J, Thompson, A G H, Weller, D (2005). How should we measure informed choice? The case of cancer screening. J. Med. Ethics 31: 192-196 [Abstract] [Full text]  
  • Giordano, L., Rowinski, M., Gaudenzi, G., Segnan, N. (2005). What information do breast cancer screening programmes provide to Italian women?. Eur J Public Health 15: 66-69 [Abstract] [Full text]  
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