The
national breast screening programme may be harming more women than it helps,
according to evidence presented to an official review.
A
prominent international specialist has recommended that the national screening
programme should be scrapped.
Prof
Peter Gotzsche said 10 women are harmed by unnecessary treatment for every
woman saved. His views have been described as "gravely mistaken" by
one doctor involved in screening. Prof Gotzsche, who holds the chair of
clinical research design and analysis at the University of Copenhagen, is part
of the Cochrane Collaboration, an international network of medical specialists.
He said: "Screening detects a lot of cancers that are not dangerous. We
call them overdiagnosed 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." The screening programme has been defended by
those involved in carrying it out. They concede that it is not a perfect
science, but insist it does save lives.
Prof
Andy Evans of Ninewells Hospital in Dundee said: "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."
Prof
Evans disputes Prof Gotzsche's assessment of the proportion of "false
positives". He added: ""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 is gravely mistaken." About two million women
are screened every year in the UK.
The
review into the effectiveness of the breast screening programme was
commissioned by Cancer Research UK and the Department of Health and is due to
report back on Tuesday. The Scottish
government says it will consider any recommendations that are made.
BBC News
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