Stakeholders' positions in the breast screening debate, and media coverage of the debate: a qualitative study

Against the backdrop of new research evidence suggesting breast screening causes avoidable harms and that women are not being given enough information to make informed decisions, we sought to explore the positions on breast screening adopted by a range of stakeholders and the coverage of this debate in the media. We sampled material from national newspapers, charity bodies’ websites and official bodies’ websites over a two-year period, and analysed this using thematic content analysis. Charities’ and official bodies’ positions were similar in that they were supportive of the NHS breast screening programme, and tended to defend it against its critics. They acknowledged, and partially explained the imperfect nature of breast screening but often omitted important information such as simple frequency statistics. There was a tendency for newspapers to cover the screening debate in an oblique way – presenting case studies of ‘real’ women and celebrities. These were mostly positive accounts of women who believed they had benefited from screening and supported the programme. Engagement with the debate in terms of discussion of the criticisms of the programme was lacking. The debate about breast cancer screening, and the increasing focus on its potential harms, received less coverage in the popular media than might have been expected. Interested stakeholder groups do make publicly available information about their positions on the relative value of screening, but these tend to focus on emphasising the potential benefits and less on the possible harms.