• Nikolaus Becker and Hans Junkermann.
• Deutsches Krebsforschungszentrum, Abteilung Krebsepidemiologie, Im Neuenheimer Feld 280, Heidelberg,Germany. n.becker@dkfz.de
• Dtsch Arztebl Int. 2008 Feb 1; 105 (8): 131136131-6.

IntroductionAn organized mammography screening program is being implemented in Germany since the end of 2005. Even before its inception, a heated debate surrounded the question of how to communicate its rationale appropriately.MethodsSelective literature review identifying facts relevant to informing decision making about mammography attendance.ResultsDecision making about individual attendance for mammography screening is crucially dependent on the reduction of risk of death from breast cancer for a diseased woman. This can be communicated in the following way: out of 100 women with a diagnosis of breast cancer 31 will die within the following 10 years without screening and 20 with screening (35% fewer).DiscussionThe actuarial concept of risk is defined by the probability of the undesired event multiplied by the expected magnitude of loss. This approach appears more appropriate for the appraisal of risk in the context of mammography screening than a pure event probability. It could help understand why women attend screening even if they perceive the risk of getting breast cancer as low--namely, that they rank the consequences of getting the disease as highly significant for themselves and others in their social environment.

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