An article in the BMJ, 24th April 2014, by Gerd Gigerenzer, says ‘All women and women’s organisations should tear up the pink ribbons and campaign for honest information’. It sets out four ways that misinformation is communicated to women invited to breast cancer screening. These are: ‘tell women what to do without stating the benefits; report relative risks only; report 5 year survival rates (which say nothing about mortality reduction); and report absolute risk reduction but use unrealistically high numbers’.
It shows just how information is skewed to give a false impression of screening benefits and calls for all misinformation to stop. The author suggests, ‘All pamphlets should show a “fact box” that explains benefits and harms in a transparent way’ and gives the example from the most recent Cochrane review for women age 50 to 69. Although the absolute reduction in mortality from breast cancer is about 1 in 1000 women, the reduction in total cancer mortality (including breast cancer) is 0 – which is ‘important because it is not always easy to determine the type of cancer from which a person died, and total cancer mortality is thus a more reliable measure’.
The Art of Risk Communication. Breast cancer screening pamphlets mislead women
BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g2636
Nothing Personal: Disturbing Undercurrents in Cancer Care
Used in medical education.
Includes referenced discussion sections for evidence-based practice.
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