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The European Journal of Public Health Advance Access published online on November 5, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckp174
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© The Author 2009. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Are women getting relevant information about mammography screening for an informed consent: a critical appraisal of information brochures used for screening invitation in Germany, Italy, Spain and France

Elisabeth Gummersbach1, Giuliano Piccoliori2, Cristina Oriol Zerbe3, Attila Altiner1, Cecile Othman1, Christine Rose1 and Heinz-Harald Abholz1,2

1 Department of General Practice, Universitätsklinikum Düsseldorf, Germany
2 South Tirolean Academy of General Practice, Italy
3 Health Centre, Barcelona, Spain

Correspondence: Elisabeth Gummersbach, Department of General Practice, Universitätsklinikum, Heinrich-Heine-University, 40001 Düsseldorf, Germany, tel: +49-211-81-16883, fax: +49-211-81-18755, e-mail: elisabeth.gummersbach{at}med.uni-duesseldorf.de

Received February 11, 2009 , accepted September 28, 2009

Background: The aim was to find out if information brochures on mammography screening in Germany, Italy, Spain and France contain more information to facilitate informed consent than in similar studies carried out over the last few years in Sweden, Canada, USA and the UK, countries with different medical cultures. Methods: We generated a list of essential information items on mammography screening for the purpose of informed consent. We mostly used the same items of information as had been used in previous studies and analysed the information brochures of major national initiatives in Germany and France, and three brochures each from regionalized programmes in Italy and Spain. We cross-checked which of our items were covered in the brochures and if correct numbers were given. Results: We found that the information brochures contained only about half of the information items we defined. Six of the eight brochures mentioned the reduction in breast-cancer fatalities. Four of the eight provided information on false positives, and four of the brochures highlighted the side-effects of radiation. The information on side-effects and risks provided by the brochures was generally of poor quality, and none of them referred to over diagnosis. When numbers were given, they were only indicated in terms of relative numbers. Conclusion: The information brochures currently being used in Germany, Italy, Spain and France are no better than the brochures analysed some years ago. Our results suggest that the providers of mammography screening programmes continue to conceal information from women that is essential when making an informed decision.

Keywords: information brochures, informed consent, mammography screening.


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