Routine breast cancer screening can do “more harm than good” and women who missed appointments should “carry on with their lives”, doctors have said.
05 May 2018 | BBC | BBC
A group of 15 health experts have written to the Times, saying women must not be subjected to “fear-mongering”.
It comes after 450,000 women in England were not invited for routine screening because of a computer error.
Breast cancer charities say the screening programme offers women the “best chance” of early detection.
In the letter to the newspaper, the group of academics and GPs say women aged 70-79 who are being offered catch-up appointments should only seek help if they notice a lump or other symptoms.
“[They] would be well advised to look this gift horse in the mouth,” the medical professionals wrote in the newspaper.
“The breast screening programme mostly causes more unintended harm than good, which is slowly being recognised internationally.
“Many women and doctors now avoid breast screening because it has no impact on all-cause death.”
The claims of lives saved because of breast screening are counteracted by deaths resulting from interventions, the medics said.
And the most dangerous and advanced cancers are not prevented by screening programmes, they said.
The letter added: “Although counter-intuitive, catching some things that look like cancer down a microscope (before it exists) can be too early and unnecessary.”
Among those who have signed the letter are Susan Bewley, professor of women’s health at King’s College London, and Michael Baum, professor emeritus of surgery at University College London.
The error, which dated back to 2009, was revealed earlier this week. Up to 270 women in England may have died because they did not receive invitations to screening.
Public Health England says it was not aware of a national problem with the screening programme until January.
It will contact the 309,000 women affected – those who are still alive – by letter by the end of May, with the offer of catch-up mammograms.
‘Two sides to the coin’
The NHS estimates that its screening programme saves about one life for every 200 women who are scanned for breast cancer, adding up to about 1,300 lives saved each year in the UK.
But about three in every 200 women screened are diagnosed with a cancer that would never have become life-threatening, equating to about 4,000 women each year being offered unnecessary treatment.
Fiona Hazell, director of policy and engagement at charity Breast Cancer Now, said it is “absolutely right” that Public Health England is offering catch-up appointments.
While research is ongoing to identify earlier which cases will progress to invasive breast cancer, the screening programme “continues to offer women the best chance of their breast cancer being detected at an early, more treatable stage – increasing the likelihood of a successful outcome,” Ms Hazell said,
Dr Emma Pennery, clinical director at Breast Cancer Care, said screening “remains our best tool” for detecting breast cancer early, but added: “There are two sides to the coin and it’s estimated that for every life saved, three women will have unnecessary treatment.”
She added: “It is crucial every woman eligible for screening is offered the opportunity to attend and receives the information they need about risks and benefits to make an informed choice about whether it’s right for them.”
Meanwhile, Sara Hiom at Cancer Research UK, said women can be “reassured” that the impact of the error is “likely to be significantly less than the worst-case scenario predictions”.
“Screening has harms as well as benefits and, while an unknown number of women will have missed the opportunity to have their breast cancer diagnosed earlier by screening, others will have avoided treatment that would not have extended their lives,” she said.
“It’s also helpful to remember that 72% of breast cancers are diagnosed by women finding a lump or noticing other symptoms themselves, so screening is not the only way of discovering something is wrong.”
Breast cancer screening is automatically offered once every three years to women aged 50 to 70 in the UK.
More than 11,000 people each year die of breast cancer, according to Cancer Research UK.
Original Link | Breast cancer screening programme ‘does more harm than good’
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