Screening mammography – none so deaf as those who won’t hear

This is a link to a post on his blog by  Richard  Smith, former editor bmj, who wonders why he cannot enrol someone to speak in favour of screening mammography.

http://blogs.bmj.com/bmj/2011/08/01/richard-smith-my-vain-search-for-a-pro-mammography-speaker/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+bmj%2Fblogs+%28Latest+BMJ+blogs%29&q=w_bmj_podblog

I feel I understand. I have seen pink fluffy blinkers being worn by just about everyone involved in, or on the fringes of, breast screening.  All are reluctant to face recent research which turns their beliefs on their heads. Yet  to carry on with the present NHS breast screening programme means  thousands of women will become ‘cancer patient’s’, undergo harsh treatments and suffer life-long side effects unnecessarily.

This is what I would write in response to Richard Smith’s letter:

I’m a breast cancer patient, medical writer and until recently was a campaigner for a national breast cancer charity. At their conference last autumn I was prevented from raising a question with Professor Mike Richards on the issue of mammography screening. No-one would discuss the matter, but delegates were urged to lobby MPs, during arranged meetings, to extend the screening age at both ends of the range. Pink fluffy blinkers! Delegates I spoke to on the subject were left in complete ignorance of recent evidence against mammography screening. I have been following and contributing to opinion on this subject over the past 2 years and believe the present screening programme to be unethical. I resigned from the group.

I have recently received an invitation to breast screening – because I am in the extended age range. This ignored my earlier response to a previous invitation declining screening (which should be on file) which informed them I would not be attending since I was under the care of a breast oncologist. If I do not turn up my medical record will be labelled DNA (did not attend). But the onus should not be on me to respond to an unsolicited invitation. If the author is convinced (despite all evidence) that screening will benefit me more than it will harm me, they should provide completely full and open information and leave me to make a fully informed decision – and an appointment, if that is my wish (patient autonomy/patient-centred service).

The (new) information leaflet (written, as before, by those with vested interests in recruiting women to screening) still does not provide honest information on potential harms – but has pretty pink flowers scattered on every page. To allay fears? Sugar the pill? Attempt to aid what could be seen as coercion?

When will there be an independent investigation into screening?
When will the information offered to women be unbiased?
And when will women be treated as if they are competent to make an informed choice?

http://www.bmj.com/content/343/bmj.d4411.full?sid=6208ba25-8bbb-44b3-a869-d77ac3a35a23

http://www.bmj.com/content/341/bmj.c3620.full?sid=6208ba25-8bbb-44b3-a869-d77ac3a35a23

A letter in The Sunday Times, 31 July 2011, M Baum et al looks at recent research that shows ‘lives saved’ are due to improved treatments and access, not to screening.

 

 

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About bmitzi

Medical writer, author, artist. Cancer campaigner. Aiming always to improve health services and bring compassion into health care.
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