Financial incentives for breast cancer screening undermine informed choice

Breast cancer is the most common cause of cancer death for women worldwide.1 Various measures have been explored to reduce breast cancer mortality. One approach is to encourage screening through financial incentives for patients or providers, as recently proposed in France and the UK, respectively.234 Several countries already use some form of incentive, and the extent to which they are being offered, in combination with ambitious screening targets, could suggest that their use is an appropriate way to promote population health. This, however, is far from clear: there are major concerns about breast cancer screening, the effectiveness of financial incentives is unclear, and there is an urgent need to ensure that women have given their valid consent—that is, informed and without undue influence—for screening. Some trans men and women and non-binary people are also eligible for breast cancer screening, and although the data mostly relate to cisgender women, the arguments on informed consent apply to everyone.