[Participation to organized screening programs: Individual and collective stakes]

Area of Science:

• Public Health
• Medical Ethics
• Health Policy

Background:

• Evaluating risk-benefit balance in public health is an ethical imperative.
• Screening involves a probabilistic approach where a larger population shares potential harms for the benefit of a few.
• Societal debates and scientific advancements continuously reshape the relationship between collective and individual interests.

Purpose of the Study:

• To trace the evolution of public discourse on cancer screening, particularly breast cancer screening.
• To analyze how health policy frameworks address collective and individual benefits of screening.
• To examine the shift towards balanced information and informed consent in screening programs.

Main Methods:

• Historical analysis of the discourse surrounding cancer screening.
• Examination of policy changes and ethical considerations in public health.
• Case study focusing on the French context of screening information and consent.

Main Results:

• The discourse on cancer screening has evolved significantly, influenced by controversies like breast cancer screening.
• Screening within a health policy context primarily offers collective benefits, followed by individual benefits.
• The debate has led to a re-evaluation of information and consent procedures for screening.

Conclusions:

• There is a shift from promoting screening to providing balanced information on benefits and risks.
• Informed decision-making for participation in screening programs is now prioritized.
• Ethical considerations necessitate a transparent approach to public health screening.