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     EDITOR—As Manaszewicz writes, the language and the framing of information items can influence the way a message is perceived (see also our box of examples).1 Regarding our use of the term harms, we are of course not "the only researchers of note to resort to such language." For example, this term is used repeatedly in the International Agency for Research on Cancer and World Health Organization report to describe the inevitable over-diagnosis and over-treatment caused by screening.2 Most people would probably consider being given an unnecessary cancer diagnosis and having a lump or a breast removed unnecessarily as harm.

    Eysenbach yawns at our study, but it shows that those responsible for screening programmes violate the principle of informed consent by omitting information on the major harms of screening. This is hardly something to yawn about but calls for a change.

    We thank Hanson for drawing our attention to our error, for which we apologise. Both of us independently and correctly classified the National Women's Health Network as an organisation that does not accept industry funding, but a mistake occurred during data transfer for statistical analysis. Since Hanson notes that the organisation is not only an advocacy group but also a consumer group, it seems most appropriate to exclude it from the analyses that compare consumer groups with other groups. This correction would lead to the same or very similar P values as those we reported in our paper, and our conclusions remain unchanged.

    Karsten J J?rgensen, physician

    Nordic Cochrane Centre, Rigshospitalet, Department 7112, Blegdamsvej 9, DK-2100 Copenhagen ?, Denmark

    Peter C G?tzsche, director

    p.c.gotzsche@cochrane.dk, Nordic Cochrane Centre, Rigshospitalet, Department 7112, Blegdamsvej 9, DK-2100 Copenhagen ?, Denmark

    Competing interests: One of the authors was involved in the systematic review of breast screening trials that questioned the value of screening.

    References

    Naylor D. Measured enthusiasm: does the method of reporting trial results alter perceptions of therapeutic effectiveness? Ann Intern Med 1992;117: 916-21.

    International Agency for Research on Cancer. IARC handbooks of cancer prevention. Vol 7. Breast cancer screening. Lyon: IARC Press, 2002.