Doctor’s letter in bmj re citizens’ jury

Referring to the use of a citizens’ jury to decide new breast screening leaflet content, Paul Pharoah, public health doctor, says Hawkes’s report of the process suggests any conclusion will be seriously flawed (BMJ 2012;345:e8576 doi: 10.1136/bmj.e8576):

“There was agreement, though the question was not put to a vote, that the leaflet should begin by citing the numbers of lives saved by breast cancer screening, 1300 a year according to the Marmot review.” So had the jury  been informed that breast cancer screening saves lives – when there is no evidence of this? ‘No randomised trial of breast cancer screening has shown a reduction in all cause mortality.’ Overtreatment is bound to increase deaths from other causes but the Marmot review chose not to evaluate all cause mortality as an endpoint – ‘a serious flaw in the reporting of the results’.

He questions whether the jury would have chosen this option had it been given accurate information about the available data – and this suggests the whole process is questionable and likely to be invalid.


About bmitzi

Medical writer, author, artist. Cancer campaigner. Aiming always to improve health services and bring compassion into health care.
This entry was posted in Breast Cancer, Campaigns, Compassion in healthcare, patient safety, patient/public involvement, Screening, Screening Mammography and tagged , , , , , . Bookmark the permalink.

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