When INCa (National Institute of Cancer France) is losing its nerve

Willing to do whatever it takes to promote screening, the INCa has just crossed a red line by qualifying as fake-news the questioning of the benefit/risk balance in breast cancer screening.

Regarding the controversy over the benefit/risk balance of breast cancer screening, INCa has always taken an openly pro-screening position. This is its right; in a scientific controversy, everyone is free to find the arguments of one side more convincing than those of the other.
What is much more questionable is that INCa is confusing information with promotion and disseminates biased information, emphasizing the effectiveness of screening and minimizing overdiagnosis and its consequences. From an official organization, we would expect fair, unbiased information, allowing women to make an informed decision.

Building on this momentum, INCa has now taken a further step by qualifying as fake-news the concern about the benefit/risk ratio of breast cancer screening (Access to the INCa website)).

It states, « Ce débat scientifique peut avoir une répercussion négative sur les femmes et les détourner de l'examen de dépistage. »(This scientific debate may negatively impact women and turn them away from the screening exam.)
Well, now! Since when to debate scientifically is a fake-news story ?
And what disregard for women who should be kept in the dark regarding the scientific controversy, because they want to reach the targets on participation rates in screening campaigns !
And what a lack of respect for the code of ethics, which imposes fair information (article 35 of the Code of Ethics)!

One can read a little further on: « Comme le montre une analyse des études scientifiques¹, les bénéfices du dépistage par mammographie sont largement plus importants que les risques » (As shown by an analysis of scientific studies (1) , the benefits of screening by mammography are largely greater than the risks).
Problem, reference (1) is nothing more than a report from ... the INCa! (1 . National Cancer Institute, "Benefits and limitations of the organized breast cancer screening program",2013).
It is obvious, if the INCa only selects studies favorable to screening and rejects the others (normal since they are fake news 😊), the conclusion of the report can be only favorable to screening.
There would be a little taste of tautology, or at least of "judge and jury" ...

When it comes to contesting the term "false cancers" to designate overdiagnosis, it is true that the expression "false cancers" is not very appropriate. But it is not completely false: the tumors corresponding to overdiagnosis are histologically cancers, it is true, but their evolution, without clinical repercussions, distinguishes them from other cancers. And this remains true even though, in the current state of knowledge, we are unable to distinguish which malignant tumor will evolve and give clinical signs and which malignant tumor will not.
In any case, the expression "false cancers" is certainly not sufficient to qualify as fake-news statements suggesting that the benefit/risk ratio of breast cancer screening may not be as favourable as the INCa claims, on the basis of studies other than those cited by the INCa (see the Cancer Rose website for another analysis of the benefit/risk ratio of screening).

Yes, INCa has lost its nerve.
One can be a strong supporter of screening. The scientific controversy is open, in France and abroad, and there are arguments on both sides.
But refusing to debate and lowering any form of contradiction to the rank of fake-news is unworthy for scientists and scandalous for an institution in charge of information on cancer.
What's next, censoring and imprisoning anyone who dares to publish or comment on the results of studies that are unfavorable to screening ?

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Dernière mise à jour le 12/09/2021