How risks of breast cancer and benefits of screening are communicated to women: analysis of 58 pamphlets.

Informed participation in population based screening programmes requires an explicit sharing of information about risks and benefits. However, many factors influence perceptions of risk and the value of risk reduction promised through screening. Campaigns that selectively quote incidence to “frighten” women into undergoing mammography have been criticised. Perceived risk, not objective risk, explains readiness to undergo screening in most models of health behaviour. Furthermore, the willingness of health purchasers to fund mammographic screening has been shown to be significantly influenced by the way in which data about effectiveness are presented: a programme achieving a 30% reduction in relative risk was more likely to be funded than two others described in terms of absolute risk reduction or numbers needed to screen to avert one death from breast cancer, even though all three were objectively identical in effectiveness. No studies have examined how risks of breast cancer and benefits of screening are communicated to women themselves.