[The biased information given to women about population screening for breast cancer makes a well considered informed choice to participate unlikely].
The 'Wet op de Geneeskundige Behandelingsovereenkomst' (Act on Agreement Concerning Medical Treatment) requires that patients are clearly informed about 'the risks and consequences that can be expected from an intended treatment or investigation'. The information received by women aged 50-74 years when invited for a biannual investigation for breast cancer does not satisfy the requirements: the available knowledge is presented too favourably and it is therefore not possible to make a well-considered informed choice to participate. For example, in the group to be screened, 4000 cases of breast cancer are diagnosed each year, yet in the information leaflet a figure of 9000 is stated, the number for all age categories. Furthermore, these 9000 cases include 1500 cases detected only as a result of screening. In the information leaflet no mention is made of the fact that 1 in 5 women will die despite screening and the risk of interval carcinomas is not examined; 40% of malignant mammary tumours are still found outside of the screening programme.
van Maanen
H
H
hvm@parool.nl
D000368:Aged; D015982:Bias; D001943:Breast Neoplasms / Q000175:diagnosis*; D003142:Communication; D003362:Cost-Benefit Analysis; D003657:Decision Making; D030881:Disclosure / Q000592:standards*; D005260:Female; D006801:Humans; D007258:Informed Consent; D008327:Mammography / Q000592:standards; D008403:Mass Screening; D008875:Middle Aged
Eenzijdige voorlichting voor vrouwen over het bevolkingsonderzoek naar borstkanker maakt geïnformeerde en weloverwogen keuze onwaarschijnlijk.