Local Biologies and Ecologies of Screening: Tracing the Aftereffects of the “Shanghai Study”

Between 1988 and 1995, the first randomized controlled trial (RCT) of breast self-exam (BSE) was conducted in Shanghai, China. Subsequent policy recommendations transformed the landscape of breast cancer screening in North America as practice guidelines shifted from “BSE” toward “breast awareness.” Critiques of the study raised issues of race, regionalism, and difference. I turn to Margaret Lock’s concept “local biology” to tease out the complexities of these arguments, and expand upon it to consider the impact of local ecologies of screening on receipt and implementation of international behavioral clinical trial results. The case study of the Shanghai trial illuminates conflicts and controversies around what constitutes evidence in breast cancer prevention research, and for whom.