1363P - Screening for breast cancer. Fear and reassurance: Impact of the recent controversy

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Breast Cancer
Aetiology, Epidemiology, Screening and Prevention
Basic Scientific Principles
Presenter François Eisinger
Citation Annals of Oncology (2014) 25 (suppl_4): iv478-iv480. 10.1093/annonc/mdu351
Authors F. Eisinger1, J. Morère2, C. Touboul3, X. Pivot4, J. Blay5, Y. Coscas6, C. Lhomel7, J. Viguier8
  • 1Oncology, IPC Inserm UMR 599, 13009 - Marseille/FR
  • 2Oncology, Hôpital Avicenne, 93009 - Bobigny/FR
  • 3Oncology, Kantar Health, 92120 - Montrouge/FR
  • 4Service Oncologie Medicale, C.H.U. Jean Minjoz, 25030 - Besancon CEDEX/FR
  • 5University Claude Bernard Lyon I, Centre Léon Bérard, 69008 - Lyon/FR
  • 6Oncology, Clinique de la porte de Saint-Cloud, Boulogne Billancourt/FR
  • 7Institutional Oncology, Roche SAS, 92650 - Boulogne-Billancourt/FR
  • 8Centre De Coordination Des Dépistages Des Cancers, CHRU Trousseau, 37044 - Tours Cedex /FR



Early detection is one of the essential tools of cancer control. Once a population has been adequately informed, primary prevention and screening are reliant upon individual behavior. There is thus, a complex interaction between knowledge, belief and psychological characteristics, which defines actual behavior. Using data from the population survey EDIFICE, we analyzed the subtle balance between fear and reassurance associated with breast cancer screening (BCS) and the impact of the recent controversy triggered by the Cochrane analysis of effectiveness and usefulness of population-based screening


A nationwide observational study, recorded in the EDIFICE iterative surveys, on a representative sample of 451 women (aged 40-75 years) living in France, was conducted in January 2013, using the quota method. The survey questionnaire was given via the computer-assisted telephone interviewing (CATI) technique 3 months after the beginning of the controversy. Our analysis focused on women with no history of cancer, and took into account individual awareness of the controversy.


Although the vast majority of women are reassured by BCS (299/405 [74%]), 160/405 (39%) declared it worried them. Interestingly, the rate of women who declared being both worried and reassured was high (105/405 [25.8%]). This ambiguity was less frequent in the group aware of the breast cancer controversy: 10/69 (15.2%) vs 93/334 (27.9%) for those who were not aware of it, P < 0.05. Women who were not aware of the controversy were globally more reassured than worried by BCS (257/334 [77.1%]) while this rate was lower (39/69 [56.6%]), P < 0.01 among those who were aware of it. Lastly, women who were not aware of the controversy gave a higher score (scale, 0-10) regarding the expected benefit of BCS: 8.9 vs. 8.3, P < 0.05.


For one out of four women, BCS is both worrying and reassuring. The perceived balance between fear and reassurance among those who were aware of the controversy is less favorable to screening since the recent media coverage. Communication around BCS should make allowances for women's potentially ambiguous feelings. A more subtle, less forthright approach may prove more appropriate and more relevant.


F. Eisinger: Board honorarium from Roche; J. Morère: Board honorarium from Roche X. Pivot: Board honorarium from Roche. All other authors have declared no conflicts of interest.