Sunday 12 February 2012

Breast cancer screening 'no longer justified' and causes 7,000 women a year to have unnecessary diagnosis

By JENNY HOPE
8th February 2012

Women should avoid breast cancer screening because it will lower their risk of getting a diagnosis of the disease, claims a leading critic of the NHS programme.

Danish scientist Professor Peter Gotzsche warned that evidence in favour of screening had become weaker as treatments have improved.

Rigorous analysis of the benefits and harms from screening show it does not reduce the overall risk of dying, or the overall risk of dying from breast cancer, he said.

A scientist warned that evidence in favour of screening had become weaker as treatments have improved
A scientist warned that evidence in favour of screening had become weaker as treatments have improved

'Women who go to screening do not live longer than women who do not go to screening.

'If mammography screening was subjected to a health technology assessment today, the recommendation would be to stop screening' he said at the launch yesterday of his new book Mammography Screening Truth Lies and Controversy in London.

Healthy women are getting unnecessary diagnoses of pre-cancerous conditions that are unlikely to develop during their lifetime, says Prof Gotzsche, director of the Nordic Cochrane Centre, Copenhagen.

He estimates 7,000 women a year receive an unnecessary breast cancer diagnosis and unnecessary treatment - including some who lose a breast - because of overdiagnosis in the NHS breast cancer screening programme.

He said: 'Screening produces patients with breast cancer from among healthy women who would never have developed symptoms of breast cancer.

'It therefore no longer seems reasonable to attend for breast cancer screening.

Around 7,000 women receive unnecessary breast cancer diagnosis and treatment
Around 7,000 women receive unnecessary breast cancer diagnosis and treatment

'In fact, by avoiding going to screening, a woman will lower her risk of getting a breast cancer diagnosis by about one-third.'

A woman will fare as well by seeing a doctor about any symptoms she has noticed, he added.

Prof Gotzsche, who is director of the Nordic Cochrane Centre, Copenhagen, and colleagues have published a number of papers since 1999 which claim the benefits of screening have been oversold and questioning 'misleading' information provided to women by governments and charities.

They conclude that recent improvements in breast cancer survival are more likely to be attributable to advances in treatment rather than screening.

Mounting controversy led to a major review into the NHS breast cancer screening programme being announced by the National Cancer Director in November, which will be led by the internationally recognised public health expert Professor Sir Michael Marmot.

Under the NHS screening programme, which cost £75 million last year, women are invited for three-yearly mammograms, or X-rays, between the ages of 50 and 70 years. The age limits are being extended to 47-73.

Almost two million women in the UK are screened each year.

Iona Heath, president of the Royal College of General Practitioners, in a foreword to the new book, praised Prof Gotzsche's work in the field.

But she warned if women become properly informed about the drawbacks of screening, the uptake may drop which will make it less cost-effective.

'However, there are huge vested interests at work and it may still take time for the limitations and harms of screening to be properly acknowledged and for women to be enabled to make adequately informed decisions' she said.

Professor Michael Baum, an international authority on breast cancer and screening sceptic, resigned from the NHS screening committee in 1995 over fears that women were being misled and has since fought for women to be given a truly informed choice.

Dr Caitlin Palframan, Policy Manager at Breakthrough Breast Cancer, said 'We believe breast screening is vital as it can detect breast cancer at the earliest possible stages when no other symptoms are obvious. The earlier breast cancer is picked up the better, as treatment options are more likely to be less aggressive and more successful.

A spokesman for the Department of Health said it would look at the findings of the independent review.

Read the original article HERE