title: [Breast cancer screening program in France: for optimization of the information].
abstract: BACKGROUND
  Based on international and national recommendations, organized breast cancer screening in France raises questions of medical ethics built around the key concepts of individual autonomy and public health policy. Because of the evolving knowledge, professionals and institutions involved in the program must review the ethical values associated with this medical practice.
  
  
  METHODS
  The ethical aspects of organized breast cancer screening were studied. In response to newly acquired knowledge highlighted by a review of texts governing this practice in France, proposals for changes resulting from reflections of a working group coordinated by the National Cancer Institute are presented.
  
  
  RESULTS
  Ethical issues raised by screening must find expression in the general principles of the program's organization: acceptability of screening, efficiency, adverse effects, equity of access, free care…, but also at different stages of the procedure: information delivery, first and second invitations, refusal of further diagnostic investigation…
  
  
  CONCLUSIONS
  A better match between breast cancer screening and recently developed knowledge requires optimal information delivery to women targeted by the program as well as a stronger role for the referring healthcare professional.
authors.affiliation: U1086 Inserm « cancers et préventions », centre François-Baclesse, avenue du Général-Harris, BP 5026, 14076 Caen cedex 5, France; Institut médico-légal, hôpital Côte-de-Nacre, CHU de Caen, 14033 Caen cedex, France; EA4569, laboratoire d'éthique médicale et médecine légale, université Paris Descartes, Paris, France. Electronic address: papinlefebvre-f@chu-caen.fr.
authors.forename: F
authors.initials: F
authors.lastname: Papin-Lefebvre
authors.affiliation: EA4569, laboratoire d'éthique médicale et médecine légale, université Paris Descartes, Paris, France; Unité de médecine sociale et éthique, hôpital Corentin-Celton, AP-HP, 92133 Issy-les-Moulineaux, France; PRES Sorbonne Paris Cité, université Paris Descartes, EHESP, équipe de management des organisations en santé, Paris V, 75005, France.
authors.forename: G
authors.initials: G
authors.lastname: Moutel
authors.affiliation: EA4569, laboratoire d'éthique médicale et médecine légale, université Paris Descartes, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Duchange
authors.affiliation: CNRS/Inserm/EHESS 2/université Paris Est - Créteil, institut de recherche interdisciplinaire sur les enjeux sociaux, 93017 Bobigny, France.
authors.forename: S
authors.initials: S
authors.lastname: de Montgolfier
authors.affiliation: Université de Montpellier, laboratoire Epsylon, 34000 Montpellier, France.
authors.forename: H
authors.initials: H
authors.lastname: Sancho-Garnier
authors.affiliation: INCa, Groupe de réflexion sur l'éthique du dépistage, 92513 Boulogne-Billancourt, France.
authors.forename: O
authors.initials: O
authors.lastname: Jullian
authors.affiliation: INCa, Groupe de réflexion sur l'éthique du dépistage, 92513 Boulogne-Billancourt, France.
authors.forename: J
authors.initials: J
authors.lastname: Viguier
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000941:ethics*; D005260:Female; D005602:France; D006801:Humans; D033181:Information Dissemination
keywords: Breast cancer; Cancer du sein; Droits des patients; Dépistage organisé; Information; Medical ethics; Organized screening; Patients’ rights; Éthique médicale