The BMJ Awards 2018: Cancer Care Team of the YearBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1244 (Published 19 March 2018) Cite this as: BMJ 2018;360:k1244
All rapid responses
Among the BMJ Awards 2018 for Cancer Care is Rupika Mehta, a consultant radiologist at Medway NHS Foundation Trust in Gillingham, for improving the delay for telling women the results of their breast screening.(1) This seems a 180° U-turn.
First, the Journal made early warnings calling for scrutiny about the breast cancer screening program in 1998.(2) Over two decades, it has been published several analysis confirming the marginal effect on breast cancer mortality and the burden of overdiagnosis.(3)
Second, the Journal also raised concerned about the organized misleading information about the benefit/harm ratio of screening.(4)
Accordingly if an award must be granted it must be to those providing to women evidence based tools for shared decision making: pictographs that use absolute numbers with a consistent denominator (ie. /1000 screened), time frames, and visuals employing the same scale for information on gains and losses of the options. Such pictographs for breast cancer screening have been implemented in the small kingdom of Belgium since 2013.(5)
1 Hawkes N. The BMJ Awards 2018: Cancer care. BMJ 2018;360:k1244
2 Reidy J, Hoskins O. Controversy over mammography screening. BMJ 1988;297:932-3.
3 Autier P, Boniol M, Koechlin A, Pizot C, Boniol M. Effectiveness of and overdiagnosis from mammography screening in the Netherlands: population based study. BMJ2017;359:j5224.
4 Gigerenzer G. Breast cancer screening pamphlets mislead women. BMJ 2014;348:g2636.
5 Braillon A, Bewley S. Shared Decision-Making for Cancer Screening: Visual Tools and a 4-Step Method. JAMA Intern Med 2015;175:1862.
Competing interests: No competing interests