'Don't think, just Pink': Knowledge and Ignorance in Public Health Policies
Résumé
Breast cancer is the most frequent cancer in human populations, particularly in industrialized countries. Concerning a woman out of twelve, its importance drove to the establishment of many public policies for its prevention, its detection and treatment. Based on the accumulation of knowledge in clinical and epidemiological areas, these public policies are often presented as canonical examples of the Evidence-based public health policies (EBPH), although they have been largely defined before the formation of the concept, derived from Evidence-Based Medicine (EBM). Based on scientific literature and recommendations for mammogram screening in many countries, this communication analyzes the ways in which the systematic mammographic monitoring of women, established in the 1980s and 1990s from previous knowledge, address new knowledge, whether produced by clinical trials, observational studies or knowledge of patients. It shows how certain knowledge are deliberately ignored or minimized, leading to very minor changes in these policies monitoring, despite growing criticism of their effectiveness or their drawbacks. Finally, we conclude by asking the question of the historicity of this type of public health policy design and the scientific knowledge they carry.
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