By Dr M.Gourmelon, June 22, 2021
INCa France: French Cancer Institute
Act 1
The citizen consultation of 2015 raised the question of breast cancer screening in France.This high-quality work resulted in a 166-page report [1] [2].
The recommendations of the steering committee were unambiguous (p133 of this document):
Translation:
« The committee proposes two scenarios for making breast cancer screening strategy to evolve and for achieving the same objective: enabling the implementation, in the coming years and with validated technological tools, of a screening strategy adapted to the level of risk. To reach this objective, the committee has made the above recommendations and proposes two ways to achieve this through one or the other of these scenarios :
- Scenario 1: Termination of the organized screening program, the relevance of a mammogram being assessed in the context of an individualized medical relationship.
- Scenario 2: Discontinuation of organized screening as it exists today and implementation of a new organized screening, profoundly modified.
Despite the clarity of the recommendation, Professor IFRAH scandalized the French medical community by denying these findings:
"The letter from the President of INCa, which is attached to the report and is supposed to summarize the report for the Minister, is edifying. Norbert Ifrah violently denigrates the first scenario. He states that "by the very admission of the report's authors"... it would be "very risky, generating inequities and loss of chance". These words are not found in the report! According to the president of INCa, "abandoning the screening program" would be "a nonsense"[3].
Act 2
Publication of the "Information booklet on organized breast cancer screening", updated in August 2017[4].
But also " Guidelines for general practitioners " " Breast cancer, from diagnosis to follow-up " (March2016). [5]
This booklet obtains a score of 6/20 when it comes to the quality of the information it provides[6].
The guidelines for general practitioners are also of "poor quality."[7]
It should be noted that these two documents, which were supposed to contain objective information on breast cancer screening by mammography, are still in effect today, June 2021, on the INCA website.
Since 2016 and March 2017, the INCA has not made the slightest revision to its documents.
Yet the INCA as a governmental health agency has a duty to provide non-partisan information.
Nevertheless, the INCA cannot ignore the strong criticisms that are addressed to it.
Thus in April 2018, in the face of the "deafness" of the INCA to these criticisms, an independent collective associating organizations ( Cancer-Rose, Que Choisir, Le Formindep, the Princeps group) and a doctor blogger editorialist on France Inter Dr. Dominique DUPAGNE, published a press release entitled "INCa provides women with incomplete and biased information on the advantages and disadvantages of following the organized breast cancer screening. "[8]
Act 3
On June 16, 2021, INCa launches "the info behind the fake-news". [9]
This is relayed by the press. [10]
Professor IFRAH, still president of INCa, presents "INCa's new heading to fight against fake news" in these terms:
"Infox, fake news or even rumors, whatever name we give them, this false information can have dramatic consequences when it concerns the health of our fellow citizens.
Unfortunately, the area of cancer does not escape it. Faced with the multiplication of these fake news, the National Cancer Institute has created this webpage to help you find out why they are false and to better understand their dangers.
Pr Norbert Ifrah, president of the National Cancer Institute. "
The press release states [11]:
"Protecting the health of our fellow citizens in the face of the development of fake news in the field of cancer"
"If some of them, unfortunately well anchored, can be characterized as "far-fetched", as for example the wearing of the bra supposed to cause breast cancer, others represent a real danger for the patients who base their hopes of cure on them. "
"This device is part of the actions of Axis 1 "Improving prevention" of the ten-year strategy to fight cancer 2021-2030, launched on February 4 by the President of the Republic. "
"Each topic proposed in this section is based on a previously identified fake new. Its deciphering follows a path that enables us to apprehend its origin, to understand why it is classified as false information and its dangerousness for each of us. "
"From June 16, the National Cancer Institute is running a campaign on digital and social networks. Its objective: to allow everyone to access the decoding of false information in the field of cancer. This campaign, which will run until mid-December 2021.... "
Who could not agree with the fight against false information? Nobody.
Unfortunately, in this section, from the very beginning, next to the famous "Far-fetched Infox" of cancer caused by wearing a bra, INCa presents the question of the interest of breast cancer screening by mammography as being an Fake new, for which it wants to demonstrate the danger[12].
We are not going to detail and analyze this page here. We will come back to it in a dedicated article.
No, what is shocking is that the INCa attributes the qualifier "Fake new" to the scientific debates that for years have been analyzing the relevance of breast cancer screening by mammography, its benefit/risk balance.
"This scientific debate may negatively impact women and turn them away from the screening exam. "
Under the pretext of "protecting the health of citizens," INCa "insults" all international scientists, the media that relay them, and all those who participate in the debate.
Moreover, as we detail in our website [13], studies that question the benefit of screening are currently more numerous than those that manage to demonstrate its usefulness.
For many years now, INCa has been "blind and deaf" [14] to everything that is scientific, to independence, to the ethics of information [15], to the exhaustiveness of information and the need to provide women with independent and reliable information in order to make an informed decision about whether or not to undergo screening.
Today, INCa is taking its "indignity" one step further.
Conclusion
This new step taken by INCa is particularly shocking for all those for whom the scientific method is not an empty word.
Scientific debate does not accept the denigration by one "camp" of those who have a contrary opinion.
The "truth" in science and medicine is enriched by debate, not by insults.
INCa believes it has the "truth" on the subject of breast cancer screening by mammography. This does not give it the right to behave as it has done for years, disregarding the debate and now resorting to unworthy denigration.
We don't know what the future will bring, but we are very concerned because today the red line, which has been crossed for many years as mentioned at the beginning of this article, has been largely left behind by INCa.
References
[1] http://www.concertation-depistage.fr/
[3] https://formindep.fr/cancer-du-sein-la-concertation-confisquee/
[6] https://cancer-rose.fr/2018/02/11/10552/
[7] https://30ansplustard.wordpress.com/2017/01/04/comment-linca-prend-les-mg-pour-des-cons/
[8] https://drive.google.com/file/d/1mxRrPz7VE-SifeQ-lha6lYjuQyAUbfWL/view
[9] https://leseclairages.e-cancer.fr/
[10] https://destinationsante.com/cancers-linca-part-en-guerre-contre-les-fake-news.html
https://fr.news.yahoo.com/cancers-l-inca-part-guerre-103158638.html
https://www.sudouest.fr/sante/cancers-l-inca-part-en-guerre-contre-les-fake-news-3788939.php
[12] https://leseclairages.e-cancer.fr/le-depistage-du-cancer-du-sein-est-il-inutile-voire-nefaste/
[13] https://cancer-rose.fr/en/category/informations-en/studies/
[14] https://pratiques.fr/Aveugles-et-Sourds
[15]
