Should numbers in addition to plain language vs. plain language alone be used for informing women about the benefits and harms of participating in an organised population-based breast cancer screening programme?

The GDG based its decision on the balance between desirable and undesirable effects that favours the intervention and the fact that the intervention would probably increase equity and is probably acceptable and feasible.

Language barriers and barriers based on numeracy and education may exist and may require specific communication strategies. The GDG developed specific recommendations on how to invite socially disadvantaged women and non-native speaking women to an organised breast cancer screening programme, these recommendations are available on our website.

The following points should be taken into account when implementing this type of intervention:

• If information (including the numbers) is not provided appropriately, confusion may arise and certain subgroups (e.g. those with less numeracy skills) may be at a disadvantage.
• The GDG considered advantageous to pre-test the presentation format before and during implementation of the recommendation.
• Information should be provided taking into account the age of the target population of the recommendation.
• According to a Cochrane review, when communicating risk reductions, relative risk reduction, compared with absolute risk reduction, may be perceived to be larger and is more likely to be persuasive (Akl EA, 2011).
• The information should be provided using the same denominators for all the outcomes presented.

​​​​Specific studies on the impact of these approaches in mammography screening should be encouraged and implemented, with particular attention to the effect on certain subgroups of the population, especially those with less numeracy skills.