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Breast screening 'should be axed'- claim

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The UK breast screening programme may be damaging more women’s lives than it saves and should be scrapped, according to a professor.

A BBC Radio Scotland investigation heard from health professionals who gave evidence to a government review into the effectiveness of screening.

Professor Peter Gotzsche of the Cochrane Collaboration, an independent organisation that investigates the effects of healthcare, told the review that for every woman’s life saved another 10 women are harmed by unnecessary medical intervention, according to the BBC investigation.

Professor Gotzsche wants the UK breast screening programme to be stopped.

“We don’t think a screening programme is justified because recent research has not found an effect on breast cancer mortality, whereas it’s clear the programme does lead to harm because many healthy women get a cancer diagnosis that doesn’t help them,” he said.

“Screening detects a lot of cancers that are not dangerous. We call them over-diagnosed cancers, they are pretty harmless.

“But many of these are treated by a mastectomy so when you introduce screening, you have more mastectomies. So seen over longer, there are more mastectomies in the screened areas. So women have seriously been misinformed throughout 30 years. It’s a public health scandal.”

But those who deliver the breast screening programme believe it saves lives.

Professor Andy Evans, Professor of breast imaging at Ninewells Hospital, Dundee, told the BBC investigation:”There is a high false positive rate because trying to tell a small cancer from a bit of normal tissue is ridiculously difficult and we can only do it as well as we do, if we read 5,000 films a year, go on lots of training and have our performance assessed on a regular basis.

“We are probably the best policed and audited group of doctors in the UK and so it’s a fault of the technology that screening mammography is in no way perfect, far from perfect, but it saves lives and it is the best we have at the moment.”

Professor Evans also disagrees that more women are harmed than saved by the screening programme.

He said: “In my opinion you save at least two women’s lives for every one case you over-diagnose. I think if we stopped the programme literally thousands of women would die of breast cancer completely unnecessarily and I think he (Gotzsche) is gravely mistaken.”

Around two million women are screened every year in the UK and around 48,000 are diagnosed with breast cancer, according to Cancer Research UK.

GP Margaret McCartney told the investigation that women are not getting enough information about both sides of the debate.

She said: “Certainly I think the benefits are much less than they have been advertised to women and I’m concerned that information that women get has been overly optimistic and really hasn’t captured the downside of screening well enough.”

The review into the effectiveness of the breast screening programme was commissioned by Cancer Research UK and the Department of Health and it is due to report back on Tuesday.

The BBC Scotland investigation will be broadcast on Radio Scotland at 4.30pm this Sunday.

<http://www.hsj.co.uk/clinical-leaders/index.html> (Clinical news/leadership)

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Readers' comments (3)

  • Does Professor Gotzsche have an alternative or is he suggesting that women resign themselves to the position that cancers are to be treated when it is obvious they are there - i.e. when the disease is in an advanced state - possible metastasised. Perhaps the focus should be on improving post screening diagnosis techniques.

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  • I wish I could remember where I read it but I found some research, albeit limited, that pointed to thermal imaging being a far more effective diagnostic tool than mammography. The write did add that further studies were needed but the research looked promising.

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  • Patrick is right until someone comes up with a better idea we need to keep the present screening programme. Waiting for a cancer to present it's symptoms is madness.
    I work for the Bowel Cancer Screening Programme and that's not perfect either but we know we are saving lives the data is already proving that.

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