Doctors, midwives, nurses, and medical specialists should provide citizens with comprehensive information on the potential harms and benefits of breast cancer screening. Women should be fully informed so they can make decisions about whether to undergo screening or not, based on their own preferences, values and risk factors, without any coercion, persuasion, or incentive.
In 2016, at the request of the Minister of Health, an independent review of the breast screening program in France was conducted, and the Steering Committee concluded that the program should either be terminated or reformed substantially. Their key recommendations included: 1) provision of neutral, comprehensive information for women, the public, and doctors; 2) acknowledgment of the scientific controversy in information for women and doctors; and 3) training for doctors to assist women in making informed decisions about breast cancer screening.
In response to these recommendations, the independent Association Cancer Rose designed a Massive Open Online Course (MOOC) entitled ‘Brest Cancer Screening — Informing Women.’ This MOOC aims to provide health professionals with the tools and techniques necessary to communicate complex information simply and effectively to better support their patients in making informed decisions. This training can also assist journalists interested in reporting public health data to avoid the pitfalls of incorrect data and misleading bias.
The course has been accredited by the French authority for medical training (DPC) and is accessible to French medical professionals via the e-learning platform 360Learning. It is built playfully, with films, quizzes, didactic ’dot’ visuals, as well as brief and varied animations.
This comprehensive, diverse, and entertaining 3-hours online course helps health professionals to comprehend and explain what is known and what remains unanswered about the potential benefits and the harms of breast cancer screening, as well as to master communication techniques to help women make an informed decision. It consists of four sections: an introduction, an analysis of the benefits of screening, a section on its harms, and a last section on how to communicate.
In the introduction, certain fundamental concepts, such as the theory of breast cancer screening and the natural history of this cancer, are discussed. A brief overview of the history of mammographic screening is described. Then, several theoretical concepts drawn from EBM (Evidence-Based Medicine) are introduced, including the comparative relevance of different types of clinical trials, their potential biases, and the criteria for judgment. The course discusses the outcomes of the randomized controlled studies that have served as the foundation for evaluating mammography screening. Finally, the course provides a decision aid tool based on evidence-based data applicable in France in two versions, adapted to different reading levels: a thorough, extensive version and a short, fun version with cartoon visuals to make information easier to comprehend and remember.
We propose extending the MOOC to students and health professionals at the international level, and we call for collaboration in creating a multi-lingual course in French, English, Spanish, and German. We welcome physicians, researchers, and academics who are interested and able to support this initiative to join us.
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