BREAST CANCER / « Cover up that controversy, which one can't endure to see »*
*the title alludes to the literary expression of famous Molière, « Cover up that bosom, which I can't endure to look on », showing the religious hypocrisy of Tartuffe.
L'Humanité Dimanche of July 8 to 21 courageously denounces, in a piece entitled « COVER UP THAT CONTROVERSY, WHICH ONE CAN'T ENDURE TO SEE” , the witch-hunt initiated by the National Cancer Institute to hide from the population the existing controversy on breast cancer screening.
Find the facts here:
https://cancer-rose.fr/en/2021/06/24/press-release-cancer-rose/ which led this institute to build the idea of a "CSA of health" in order to "eliminate" a worldwide scientific debate, and especially the existence of divergent studies freely qualified as "fake-news". This is integrated in the "roadmap" of the INCa for the ten-year strategy of the future cancer plan.
The article in HUMANITE-DIMANCHE reminds us that this institute, bound to neutrality, has still not responded to citizens' expectations formulated in the 2016 report on screening consultation, in which we can read, on page 133, the request for a halt to this screening as it is currently carried out, and at least the provision, for women, of information also concerning the damage of this screening, instead of the current very optimistic presentation.
Women must be able, on the basis of good information, to accept or refuse screening, without feeling guilty.
The author of this article, Ms. Anne-Corinne Zimmer, rightly reminds us that "it took the mobilization of the magazine Prescrire, Que choisir organization, the Cancer rose collective, etc., to push the INCa to introduce few phrases of information on the benefits-risks balance ».
In 2021, therefore 4 years later, the National Cancer Institute, whose role is to inform the public, has still not published a real neutral information tool for women on the benefit-risk balance of screening, it conceals over-treatment and still minimizes the number one problem of screening, which is not radiation-induced cancer, that INCa puts forward as a shield on its "enlightenment" site, but it is the over-diagnosis, which according to modern studies, could well concern one cancer out of two detected.
As the writer of the article very bravely concludes:
“Wanting to silence all controversy can only lead to more and more distrust among the population.”
The article, translated
Author: Anne-Corinne Zimmer
L'HUMANITE DIMANCHE, 8 to 21 July 2021
BREAST CANCER / « Cover up that controversy, which one can't endure to see »*
*the title alludes to the literary expression of famous Molière, « Cover up that bosom, which I can't endure to look on », showing the religious hypocrisy of Tartuffe.
Organized screening remains at the heart of the strategy to fight breast cancer for the next decade. The National Cancer Institute (INCa), the dedicated french governmental agency and committed to neutrality, has set up a website to fight against everything it considers as "fake news" on the subject. At the risk of ignoring plural information on a procedure that has been debated for 20 years.
Silencing the scientific controversy that has existed since the 2000s on the issue of organized breast cancer screening by mammography, is on the roadmap of the National Cancer Institute's (INCA) strategy for the next ten years (1).
Indeed, this is not stated in this way, but it is well mentioned in the national strategy for the fight against cancer 2021-2031: action 1.2 refers to "the set up of a reactive system to combat fake news". This system is already effective with the launch of the website “Enlightenments” (2) in early June 2021, on which one will search in vain for studies diverging from the Institute's position in favor of organized breast cancer screening alone. Yet the controversy has existed for decades around the world.
The INCa further adds in its roadmap : "A reactive anti-fake news system will be structured (...). It is important to better inform public opinion, especially by using data that makes tangible the effects of prevention (international benchmarks, results of studies...). In addition, without being limited to the field of cancer, the creation of a "CSA Health"**type system will be studied, to implement rules for information in health, provided in a framework agreement with content hosts (media, social networks) to do a work of eliminating fake news identified by a college of experts."
**CSA is the French acronym of “Conseil Supérieur de l'Audiovisuel », which is the French regulator of audiovisual.
FAKE OR DIVERGENT STUDIES?
"A priori it seems to be a good idea," recalls Jean Doubovetzky, doctor and member of the collective Cancer rose, non profit organization for the information of women on the organized screening of breast cancer, except that "to appoint a college of experts who would have the power to decree that an information given in any field of health is a fake news, and to impose to the media and to the social networks its elimination, in other words its censorship" it is at least a strange idea. Therefore, how can one keep a critical thinking, if research and studies diverging from INCa's opinion are not presented?
FORGOTTEN RECOMMENDATIONS
And the precedents do not plead in favor of the INCa. At the end of the 2016 citizen consultation, which included a panel of scientists and a panel of citizens (see below), both recommended stopping organized screening and, as a second option, recommending that organized screening be stopped as currently practiced and to be completely reviewed - supported in particular by clear information for women on the benefits and risks balance. In the final report of consultation (3), the first recommendation is " to take into consideration the controversy in the information provided to women and in the information and training (initial and continuous) of professionals ", as well as " decision support tools to empower women to make their choice, i.e. to accept or refuse the invitation to participate in organized screening ".
11,000 TO 12,000 DEATHS PER YEAR
The citizens' panel of the orientation committee to improve breast cancer screening www. concertation-depristage.fr gathered in 2016 recalled that "(they) do not wish(wished) to keep the policy of organized screening as it is currently defined and applied” _, because it should be "accompanied by clear and neutral comprehensive information to understand the benefit-risk balance of participation and information tools for decision-making”. For the conference of professionals (researchers and physicians), they expected "a decrease in mortality from this cancer-which in France, from the 1960s to nowadays, is around 11,000 to 12,000 deaths annually”.
Organized screening abandoned in Switzerland
The INCa responded: "Abandoning screening on the pretext that its tools are perfectible would be (...) a nonsense", while ignoring the proposals. Two years later, information on the benefit-risk ratio was still not included in the letter of invitation to organized screening received by women over 50 years of age.
It took the mobilization of independent medical journal "Prescrire", “Que choisir” organization, Cancer rose collective and of the doctor and columnist Dominique Dupagne (Atoute.org) to push the INCa to introduce few phrases of information, three years later ... and only about the risks of "radiation-induced cancer", which is just one of the aspects on the benefits-risks balance. When Switzerland, for example, abandoned the extension of the organized screening on the basis of a public consultation.
The decision aid guides and other tools for forming the judgment of population are ignored by this health agency. People should not only rely on INCa, on its hunt for "fake news" and its references to its own studies, but should make the effort to visit the WHO dedicated website (https://www.euro.who.int) or the Cancer rose website (cancer-rose.fr/ ), which provides information and brochures distributed with the invitation to the organized screening in countries other than France. Refusing a scientific and human debate, which is necessarily controversial, would not be a substitute for a prevention policy, since the arguments are on both sides.
Wanting to silence all controversy can only lead to more and more distrust among the population.
ANNE-CORINNE ZIMMER
(1) The implementation of organized breast cancer screening in France began in 2004.
(2) https://leseclairages.e-cancer.fr/le-depistage-du-cancer-du-sein-est-il-inutile-voire-nefaste/
(3) Report of the steering committee, citizen and scientific consultation (September 2016), p. 127. Available at www.concertation-depistage.fr