Steckelberg et al brilliantly showed that risk information on
colorectal cancer screening improved knowledge, allowing for increased
informed choices, but did not affect the uptake of screening.(1)

The situation may be different for breast cancer screening which is
under scrutiny.(2) Welch dares to ask how often overdiagnosis occurred with
mammography screening.(3) Moreover, in Denmark, a recent evaluation by a
case control study showed similar or lower reductions in breast cancer
mortality in screening regions compared to non-screened areas and in age
groups too young to benefit from screening.(4)

Whatever is the response, France has little concern for such issues.
The mandatory health insurances authority (French Health Insurance Fund
National Authority, UNCAM) published guidance in the official gazette of
the French Republic: ? the general practitioner draws the patient's
attention to the benefits of (breast cancer) screening ... produces
positive information about screening...which naturally falls within the
scope of mere monitoring... in order to remove the reticences of his
patients ... (5) This did not preclude the participation rate to stagnate
at a 52% level.

Sadly, there is no hope for change because questioning inappropriate
public health policies seems dangerous in France.(6,7)

1.Steckelberg A, H?lfenhaus C, Haastert B, M?hlhauser I. Effect of
evidence based risk information on "informed choice" in colorectal cancer
screening: randomised controlled trial. BMJ. 2011 Jun 2;342:d3193. doi:
10.1136/bmj.d3193

2 Baum M, Thornton H, G?tzsche PC et al. Breast cancer awareness
month. Still awaiting screening facts. BMJ. 2010;341:c6152

3 Welch GH. Overdiagnosis and mammography screening. BMJ
2009;339:b1425

4 J?rgensen KJ, Zahl PH, G?tzsche PC. Breast cancer mortality in
organised mammography screening in Denmark: comparative study. BMJ 2010;
340:c1241

5 UNCAM, CSMF, SML, Alliance. Arr?t? du 2 mai 2007 portant
approbation de l'avenant n? 23 ? la convention nationale des m?decins
g?n?ralistes et des m?decins sp?cialistes. Journal Officiel de la
R?publique Fran?aise 2007, n?103 (3 May), 7826. Available at
http://www.legifrance.gouv.fr/WAspad/UnTexteDeJorf?numjo=SANS0752329A
Accessed 2011 June 7

6. Freeman B, Dubois G. Abuse of libel laws and a sacking: The
gagging of public health experts in France. Tobacco control blog BMJ group
8 Nov 2010. Available at http://blogs.bmj.com/tc/2010/11/08/abuse-of-
libel-laws-and-a-sacking-the-gagging-of-public-health-experts-in-france/
Accessed 2011 June 7.

7 Benkimoun P. Doctor's sacking is setback for French public health.
BMJ 2010; 340:c711