[Breast cancer screening: ethical problems. The Strasbourg experiment. Deontological issues raised by breast cancer screening: quality assurance and accreditation of structures]
Cancer of the breast is so widespread that it has become a genuine problem of public health, with around one woman in twelve developing it in her lifetime. Mass breast-cancer screening campaigns began some 30 years, first in the United States and then in Sweden. Results showed a lowering of the breast-cancer-related death-rate. French doctors experienced considerable difficulties in changing over from an individually-focused organization to the kind of public healthcare service that exists in Nordic and Anglo-saxon countries. However, the first departmental-level breast-cancer screening program, launched in Strasbourg, France, in 1989 proved successful inasmuch as it obtained the involvement of the vast majority of radiologists and general practitioners. Results of the campaign were broadly in line with those obtained elsewhere in Europe. It is only possible to bring this sort of campaign into wider use through intensive groundwork and by providing suitable training for general practitioners, radiologists and gynecologists alike.