[Screening: ethical principles]

Mass cancer screening is new in France inasmuch as the country has never up to now carried out such a large-scale and wide-reaching public healthcare operation. The organisation of the screening brings up the question of where healthcare is actually heading. Should the community as a whole should have preference over the individual or, on the other hand, should the individual and his or her private life be defended against a faceless community that is becoming more and more demanding? This question is fundamental to all the difficulties that are met when organising mass screenings. There are, of course, certain technical aspects and indicators of effectiveness that are common to all screening campaigns, but there are also wider considerations that must be respected, such as social justice and liberty of both the individual and the community. Anyone who wishes to take advantage of the screening should be free to do so, but the individual must also be free to refuse. Screening must remain voluntary. It is essential to maintain full data secrecy and to provide appropriate training for the doctors involved. It is also of fundamental importance to carry out an assessment of the campaign from a neutral angle. The training issue is crucial, with the doctor's suitability to carry out the test a key factor. Doctors need to be trained to acquire the necessary skills, especially as it will soon become necessary to monitor doctors' competence in the field. An assessment will have to be made not simply of performance but also of doctors' ability to handle a given situation.