Epidemiology Unit, CPO Piemonte, AOU S. Giovanni Battista, Turin, Italy.
J Med Screen. 2012;19 Suppl 1:67-71. doi: 10.1258/jms.2012.012084.
Despite the difficulties, there is a moral responsibility to provide the public with the best estimates of benefits and harms of breast cancer screening.
In this paper we review the issues in communication of benefits and harms of medical interventions and discuss these in terms of the principles of the balance sheet proposed in this supplement.
The balance sheet can be seen as a tool to convey estimates based on the best available evidence and addressed to a readership wider than just potential screening participants. It reflects a re-assessment of screening efficacy, showing again that screening is effective and brings more benefits than harms. It can be viewed as an opportunity to re-affirm some basic principles of good evidence-based communication. Further research is needed to improve communication strategy, to assess the impact of this communication on women's awareness and to evaluate its utility in the informed decision-making process.
The balance sheet could be a starting point for a broader vision of informed decision-making in screening, which should also recognize the role played by 'non-numerical' factors on women's choice of participating in breast cancer screening.
尽管存在困难，但有责任向公众提供乳腺癌筛查的最佳益处和危害估计。
在本文中，我们回顾了沟通医疗干预措施的益处和危害的问题，并根据本增刊中提出的平衡表原则讨论了这些问题。
平衡表可以被视为一种工具，用于根据最佳现有证据传递估计值，并针对的读者群体不仅限于潜在的筛查参与者。它反映了对筛查效果的重新评估，再次表明筛查是有效的，并且带来的益处多于危害。它可以被视为重新确认一些良好循证沟通基本原则的机会。需要进一步研究以改善沟通策略，评估这种沟通对女性意识的影响，并评估其在知情决策过程中的效用。
平衡表可以成为更广泛的筛查知情决策的起点，也应该认识到“非数值”因素在女性选择参与乳腺癌筛查方面所起的作用。
