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NHS 'failing to inform' women of breast cancer screening risks

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Women undergoing NHS breast cancer screening are being “misinformed” and are not told about the harms of over-diagnosis, researchers have claimed.

Those running the NHS breast cancer screening programme have “stuck to” beliefs from 25 years ago about the benefit of mammograms and supply women with “astonishingly misleading” statistics on death rates, they added.

Furthermore, the NHS fails to give women “an informed choice” because its literature lacks balance and ignores criticism of the programme.

Writing in the Journal of the Royal Society of Medicine (JRSM), researchers from the Nordic Cochrane Centre in Denmark said the risks of over-diagnosis had been downplayed.

They called for more honesty from those behind the NHS programme, adding: “Spokespeople for the programme have stuck to the beliefs about benefit that prevailed 25 years ago.

“Concerns about over-diagnosis have not been addressed… and official documents still downplay this most important harm.

“Women therefore cannot make an informed choice whether to participate in screening based on the information the programme provides. This must be changed.”

The paper says information provided by the NHS breast cancer screening programme regarding lives saved is greatly exaggerated.

“The claim that death rates have fallen ‘in part from earlier diagnosis associated with screening’ is astonishingly misleading,” said Professor Peter Gotzsche, co-author of the paper and director of the Nordic Cochrane Centre.

For the programme, it has been estimated that screening prevents one breast cancer death for every 400 women screened regularly over 10 years.

But the researchers argue this calculation “is wrong by a factor of five”.

“We have been unable to find any evidence for this estimate in reports from the programme or elsewhere.”

A spokeswoman for the Department of Health said: “According to the vast majority of experts, the evidence shows that breast screening reduces deaths from breast cancer.

“The NHS Breast Screening programme is based on the best available evidence and in line with the recommendations of the World Health Organisation.

“Experts estimate that the NHS Breast Screening programme saves the lives of 1,400 women each year.”

The NHS Breast Screening Programme in England is currently being extended to women aged 47 to 73.

Screening is currently routinely offered every three years to women aged 50 to 70.

Professor Julietta Patnick, director of the NHS Cancer Screening Programmes, said: “These criticisms have been raised a number of times before by the same authors and have been comprehensively rebutted in the public domain each time.”

She added: “Recent peer-reviewed estimates suggest that screening saves one life per 400 women screened over a 10-year period, and that 97% of women with screen-detected cancers are alive five years later compared to just over 80% of all women diagnosed without screening.”

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