Implications and details of the responsibility of radiologists in organized screening activities

: Medical responsibility in screening activities. In 1992 a national breast cancer screening programme was launched by the ministry of health in Luxembourg. This programme refers to the "European Guidelines for quality assurance in mammography". This screening is non-centralised: the analog mammograms are performed in 9 Hospital radiology departments. The first reading is done in the hospital department by a radiologist. The mammograms are then sent to the Coordination Centre for encoding and a second reading. If needed, a decision is reached by consensus in a third reading. The Coordination Centre is in charge of tracking positive cases, follow-up of quality assurance, training and epidemiological evaluation of the programme. Radiologists and radiographers are requested to renew their certification on a regular basis. In the frame of elaborating guidelines for good practice for all participants, radiologists have organised a debate about the legal responsibility of radiologists who are participating as first or second readers. The same was done for radiographers, secretaries, hospital administrators and the staff of the Coordinating Centre. This debate has brought together all radiologists and representatives of the ministry of health, comprising a legal adviser and an external expert acting for the Court of Paris, being himself a radiologist which specific medical training and activities in mammography. The main conclusion of this debate is the entire responsibility of the first reader in the frame of this medical activity, which is taking place under well specified predefined procedures.