Women need better information on routine mammography

Editor—I read the paper by Thornton et al and the reply by Patnick (see next letter) with interest.¹,² Both the NHS breast screening programme and cervical screening programme have made great efforts to improve the understanding by women of the principles of screening since Anderson and I wrote a paper in 1999 that was critical of the information given.³ Unfortunately there is clearly someway to go.

Patients remain confused. The BBC, quoting from a report by the Cancer Research UK psychosocial oncology group at the University of Sussex, says that patients were flummoxed by terms used to describe screening procedures for breast and bowel cancer and that more than half of the study group either did not know or showed partial understanding of breast cancer screening techniques such as mammography.⁴

Disappointingly, the leaflet to which Patnick refers (Breast screening the facts) omits to mention the potential consequences of being screened—namely, invasive biopsy procedures or even mastectomy, with their attendant morbidity.² Although these eventualities may only affect a minority of those being screened, they are surely worthy of mention in a pamphlet purporting to tell it how it is, especially since most of these women are healthy before undertaking the screening test.

Given the time and effort spent in ensuring that bereaved relatives are given appropriate information before their next of kin undergoes a postmortem examination, surely it is time the opportunity to provide truly informed consent was given to participants in screening programmes so they know exactly what they are signing up to.