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Recent geographical scholarship has drawn attention to the ways in which the practice of public health constructs particular bodies and populations as "risky." From a biopolitical perspective, this status of being "at risk" offers the basis for an emergent biosociality, groups brought together by a shared vulnerability to disease, which then forms the basis for both state‐led public health interventions and community‐driven advocacy and support. Critics, however, suggest a focus on biosociality can act to obscure other dimensions of individual and community identity, dimensions that can play a key role in determining both health status and the success of healthcare interventions. This paper draws together insights from geography, anthropology, and sociology with empirical evidence from focus groups collected as part of an evaluation of a breast cancer awareness DVD distributed in the London borough of Hackney. We explore the extent to which the DVD, by defining a specific group (black women aged 25–50) as being at increased risk of developing more severe forms of breast cancer at a younger age, led to the formation of a biosocial community. Themes emerging from the analysis of focus group transcripts present a complex picture. At times our participants clearly aligned themselves with this biosocial collective, drawing on a shared Black political identity, assumptions of a common African genetic heritage, experiences of diaspora, and perceived similarities in lifestyles and bodily norms. At other times, however, this shared sense of belonging fragmented in light of perceived differences in culture, lifestyle, and community which nuanced both participants' sense of being "at risk" and how they might (or might not) seek to manage that risk. Our findings suggest that biosociality is a fragile and heterogeneous accomplishment, with implications for the way we practise medical and social science research, design community‐targeted public health interventions and conceptualise risk.

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made ; BACKGROUND: Observational studies have reported conflicting results on the impact of mammography service screening programmes on the advanced breast cancer rate (ABCR), a correlation that was firmly established in randomized controlled trials. We reviewed and summarized studies of the effect of service screening programmes in the European Union on ABCR and discussed their limitations. METHODS: The PubMed database was searched for English language studies published between 01-01-2000 and 01-06-2018. After inspection of titles and abstracts, 220 of the 8644 potentially eligible papers were considered relevant. Their abstracts were reviewed by groups of two authors using predefined criteria. Fifty studies were selected for full paper review, and 22 of these were eligible. A theoretical framework for their review was developed. Review was performed using a ten-point checklist of the methodological caveats in the analysis of studies of ABCR and a standardised assessment form designed to extract quantitative and qualitative information. RESULTS: Most of the evaluable studies support a reduction in ABCR following the introduction of screening. However, all studies were challenged by issues of design and analysis which could at least potentially cause bias, and showed considerable variation in the estimated effect. Problems were observed in duration of follow-up time, availability of reliable reference ABCR, definition of advanced stage, temporal variation in the proportion of unknown-stage cancers, and statistical approach. CONCLUSIONS: We conclude that much of the current controversy on the impact of service screening programmes on ABCR is due to observational data that were gathered and/or analysed with methodological approaches which could not capture stage effects in full. Future research on this important early indicator of screening effectiveness should focus on establishing consensus in the correct methodology.

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. ; The study is funded by a National Awareness and Early Diagnosis Initiative (NAEDI) project grant awarded by Cancer Research UK and a consortium of funders (Department of Health (England); Economic and Social Research Council; Health and Social Care R&D Division, Public Health Agency, Northern Ireland; National Institute for Social Care and Health Research, Wales; Scottish Government). JW, MR, RB and AM are supported by Cancer Research UK. SMJ is a Wellcome Trust Senior Fellow in Clinical Science and is supported by the Rosetrees Trust, the Welton Trust, the Garfield Weston Trust and UCLH Charitable Foundation. This work was partially undertaken at UCLH/UCL who received a proportion of funding from the Department of Health's NIHR Biomedical Research Centre's funding scheme (SMJ). SMJ is also funded by the Roy Castle Lung Cancer Foundation and is part of the CRUK Lung Cancer Centre of Excellence. SLQ is supported by the Medical Research Council.

Lung cancer screening with low-dose CT can save lives. This European Union (EU) position statement presents the available evidence and the major issues that need to be addressed to ensure the successful implementation of low-dose CT lung cancer screening in Europe. This statement identified specific actions required by the European lung cancer screening community to adopt before the implementation of low-dose CT lung cancer screening. This position statement recommends the following actions: a risk stratification approach should be used for future lung cancer low-dose CT programmes; that individuals who enter screening programmes should be provided with information on the benefits and harms of screening, and smoking cessation should be offered to all current smokers; that management of detected solid nodules should use semi-automatically measured volume and volume-doubling time; that national quality assurance boards should be set up to oversee technical standards; that a lung nodule management pathway should be established and incorporated into clinical practice with a tailored screening approach; that non-calcified baseline lung nodules greater than 300 mm3, and new lung nodules greater than 200 mm3, should be managed in multidisciplinary teams according to this EU position statement recommendations to ensure that patients receive the most appropriate treatment; and planning for implementation of low-dose CT screening should start throughout Europe as soon as possible. European countries need to set a timeline for implementing lung cancer screening.