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“Citizens’ jury” disagrees over whether screening leaflet should put reassurance before accuracy

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8047 (Published 26 November 2012) Cite this as: BMJ 2012;345:e8047
  1. Nigel Hawkes
  1. 1London

A “citizens’ jury” of 25 women, assembled this week to provide advice for the drafting of a new leaflet on breast cancer screening, has reached consensus on some of the tricky issues.

The leaflet is being rewritten after criticism that it conveyed a falsely optimistic message and in the light of the Marmot review of breast cancer screening, which found that women invited to mammographic screening were three times as likely to be “overdiagnosed” as they were to have their lives saved.1

The jury did not draft a new leaflet or the covering invitation letter that will accompany it but did consider some of the central issues to be considered by those who will draft them. For example, the jury preferred the term “overtreatment” to “overdiagnosis” by a majority of 21 to four, on the grounds that it was easier to understand, and also preferred expressing benefits in terms of lives saved rather than deaths avoided, though by a smaller majority.

One juror said that lives saved set a more upbeat message than deaths avoided. Put to the vote, 13 women favoured lives saved and three preferred …

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