Risks of health surveillance: the case of mammography screening in Norway
Public Health and General Practice Norwegian University of Science and Technology Trondheim, Norway
Mammography screening for breast cancer is common in most European countries. Mammography screening is health surveillance technology meant to minimize women's risk of dying from breast cancer. In Norway the mammography programme invites all women aged 50-69, and has a participation rate of more than 70 per cent. Its aim is to reduce breast cancer mortality by 30 per cent through its early detection of breast cancer, preferably at a pre-symptomatic stage.
Women who participate in mammography screening are non-symptomatic. Through screening they are put at risk for a breast cancer diagnosis which may be true or false, but which in any case induces their entry into cancer treatment regimes. Debates on the risk of over-diagnosis from mammography screening are presently taking place in medical journals. Women themselves do however worry more about the potential of having a false negative mammography screen (Solbjør 2008).
This paper will explore whether mammography screening, with its potential to save women from breast cancer death, also could be seen as a health risk. Based on interviews with women who receive a breast cancer diagnosis between screening rounds, the paper asks how these women interpret mammography screening. A central point here is how women experience receiving their breast cancer diagnosis in the interval between screening rounds while being participants in a screening programme. Women who are invited to the Norwegian mammography programme are glad to be enrolled into the programme (Østerlie et al 2008). This paper will examine whether their positive attitude towards mammography screening remains after having an interval cancer. It raises questions of whether mammography screening is saving the lives of some women, while putting other women at risk for a false diagnosis and untimely or delayed medical intervention.