Abstract
Over the last few years, there has been growing international concern about the risk of overdiagnosis in breast screening and about how to communicate this to women. There has also been an increasing policy drive to provide people with information to enable them to make an informed choice about screening. In response to this, a novel approach to developing the information about cancer screening has been adopted in England. This approach has integrated the perspectives of people eligible for screening, and experts in public engagement, informed choice, and communicating risk, as well as experts in screening. New information based on this approach has been provided to women invited for breast screening from September 2013. The new information explicitly sets out the choice to be made, and provides much more detail than previous information about overdiagnosis, the balance of benefits and harms, and the scientific uncertainties. The novel approach has also been adopted to develop new information for the bowel and cervical screening programmes in England, and could provide a model for communicating about cancer screening in other countries.
| Original language | English |
|---|---|
| Pages (from-to) | 194-200 |
| Journal | Journal of Medical Screening |
| Volume | 21 |
| Issue number | 4 |
| Early online date | 13 Oct 2014 |
| DOIs | |
| Publication status | Published - 1 Dec 2014 |
Bibliographical note
Funding: The development of the approach to information about cancer screening and the development of the new breast screening information were funded by NHS Cancer Screening Programmes. However, these were carried out at arm’s length from the NHS Cancer Screening Programmes. The Director of NHS Cancer Screening Programmes reviewed and commented on the manuscript and approved the final version.Authors’ contributions: LJL Forbes and AJ Ramirez led the drafting of the manuscript and led the development of the novel approach to cancer screening information and the new information about breast screening. A Coulter, J Dewar, R Felton, A Jones, M Michell, M Reed, J Rule, D Spiegelhalter and P Whelehan made a major contribution to the Citizens’ Jury. M Archer, J Cooke, A Coulter, V Entwistle, R Felton, J Kirby, M Reed, J Rule, D Spiegelhalter, D Spika, and R Wilson made a major contribution to the development of the breast screening information. All authors reviewed and commented on the manuscript and approved the final version.
Acknowledgments: The authors thank the women who took part in the Citizens’ Jury and the cognitive testing, members of the Advisory Committee on Information about Cancer Screening and the Advisory Committee on Breast Cancer Screening, for providing expert input into the development of the breast screening invitation letter and leaflet, the Office of Public Management, in particular Deborah Rozansky, Zoe Khor and Sanah Sheikh, for setting up and facilitating the Citizens’ Jury, BMG Research for conducting the cognitive testing of the invitation letter and leaflet, everyone who participated in the consultation, and Elliann Fairbairn and Louise Smith for managing the project.
