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Estimation of lead time and overdiagnosis in breast cancer screening.

https://arctichealth.org/en/permalink/ahliterature90543
Source
Br J Cancer. 2009 Jan 13;100(1):219; author reply 220
Publication Type
Article
Date
Jan-13-2009
Author
Gøtzsche P C
Jørgensen K J
Maehlen J.
Zahl P-H
Source
Br J Cancer. 2009 Jan 13;100(1):219; author reply 220
Date
Jan-13-2009
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - diagnosis - epidemiology
Female
Humans
Mass Screening - methods
Sweden - epidemiology
Notes
Comment On: Br J Cancer. 2008 Oct 7;99(7):1176-818766185
PubMed ID
19127274 View in PubMed
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Informed choice requires information about both benefits and harms.

https://arctichealth.org/en/permalink/ahliterature95279
Source
J Med Ethics. 2009 Apr;35(4):268-9
Publication Type
Article
Date
Apr-2009
Author
Jørgensen K J
Brodersen J.
Hartling O J
Nielsen M.
Gøtzsche P C
Author Affiliation
The Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark. kj@cochrane.dk
Source
J Med Ethics. 2009 Apr;35(4):268-9
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Bias (epidemiology)
Breast Neoplasms - radiography
Decision Making - ethics
Decision Support Techniques
Early Detection of Cancer
Female
Humans
Informed Consent - ethics - psychology
Mammography - ethics
Patient Education as Topic
Risk factors
Abstract
A study found that women participating in mammography screening were content with the programme and the paternalistic invitations that directly encourage participation and include a pre-specified time of appointment. We argue that this merely reflects that the information presented to the invited women is seriously biased in favour of participation. Women are not informed about the major harms of screening, and the decision to attend has already been made for them by a public authority. This short-circuits informed decision-making and the legislation on informed consent, and violates the autonomy of the women. Screening invitations must present both benefits and harms in a balanced fashion, and should offer, not encourage, participation. It should be stated clearly that the choice not to participate is as sensible as the choice to do so. To allow this to happen, the responsibility for the screening programmes must be separated from the responsibility for the information material.
PubMed ID
19332586 View in PubMed
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