Screening mammography: research references and links

The Cancer Czar has called for a review of the NHS Breast Screening Programme because more and more research is showing it causes as much harm as benefit, with no reduction in mortality. Here are some of the research papers and articles:

Further references – screening mammography poster NCRI conference, November 2011.

*COCHRANE LEAFLET: screening for breast cancer with mammography

Breast cancer screening is to be reviewed, cancer tsar announces. Nigel Hawkes BMJ 2011;343:doi:10.1136/bmj.d6905 (Published 26 October 2011)

An independent review is under way. Richards M. BMJ 2011; 343:d6843 doi: 10.1136/bmj.d6843 (Published 25 October 2011)

Does breast screening do more harm than good? A new UK review of the benefits & harms of screening is welcome, but what we really need is better evidence. M. Baum 3 November 2011. 


To suggest a topic for NICE (eg breast screening):

Considering when it might be best not to know about cancer. Gina Kolata. News Analyses. The New York Times National, Sunday 30 October 2011.

M Baum’s UCL Lunchtime Lecture. ‘Breast screening: some inconvenient truths’ 28 October 2010. Accessed 4 November 2011.


Science in Parliament. Baum M.Vol 66 No 4. Autumn 2009. The Journal of the Parliamentary and Scientific Committee, p 12-13.


Likelihood that a woman with screen-detected breast cancer has had her ‘life saved’ by that screening. H. Gilbert Welch, MD, MPH; Brittney A. Frankel

Arch Intern Med. Published online October 24, 2011. doi:10.1001/archinternmed.2011.476

Who evaluates public health programmes? A review of the NHS Breast Screening Programme. Jorgensen KJ, Gotzsche PC. JR Soc Med 2010;102:14-20.

An economic evaluation of the war on cancer. Goldman D, Jena AB, Lakdawalla D, Philipson T, Reyes C, Sun E.VOX 11 January 2010. concluded 90% of mortality reduction CAB in last decades due to treatment improvements NOT early detection.

The Natural History of Invasive Breast Cancers Detected by Screening Mammography. Per-Hendrik Zahl, MD, PhD et al Arch Intern Med. 2008;168(21):2311-2316.

The Art of Medicine, Decision-Making and Fear in the midst of Life. Aronowitz R. Vol 375 April 24, 2010.

Systematic review of screening for breast cancer with mammography. Olsen O, Gotzsche PC. The Nordic Cochrane Centre. Published October 20, 2001.

Screening for Breast Cancer with Mammography (Review). Gotzsche PC, Nielsen M. The Cochrane Library 2009, Issue 4.

Screening for breast cancer – balancing the debate. Klim McPherson.

BMJ 2010; 340:c3106

‘Well, have I got cancer or haven’t I?’ The psycho-social issues for women diagnosed with ductal carcinoma in situ. De Morgan S, Redman S, White KJ, Cakir B, Boyages J. Health Expectations. 5: Dec 2002:310-318.

Women need better information about routine mammography. Thornton H, Edwards A, Baum M. BMJ 2003; 327:101-3.

Women’s information needs about ductal carcinoma in situ before mammographic screening and after diagnosis: a qualitative study. Prinjha S, Evans J, Mcpherson A. J Med Screen 2006; 13:110-114.

‘A Mastectomy for something that wasn’t even truly invasive cancer’. Women’s understandings of having a mastectomy for screen-detected DCIS: a qualitative study S Prinjha S, Evans J, Ziebland S, McPherson A. J Med Screen 2011; 18:34-40.

Treatment of ductal carcinoma in situ Julia A Smith. BMJ 2011;343:d5344 19 September 2011. and response by Miriam Pryke 9 October 2011

Time for a Screen Break? Large-scale medical screening is meant to save lives, but critics say that it only causes needless suffering. John Naish, The Times Newspaper 6 September 2011, Section 2:

It is not wrong to say no. Iona Heath, general practitioner, London. BMJ 2009;338:b2529

Breast cancer mortality in neighbouring European countries with different levels of screening but similar access to treatment: trend analysis of WHO mortality database. Autier P, Boniol M, Gavin A, Vatten LJ. BMJ 2011; 343:d4411.

Breast cancer mortality in organised mammography screening in Denmark. A comparative study. BMJ 2010;340:c1241. Jorgensen KJ, Zahl PH, Gotzsche PC.

Effect of Screening mammography on Breast Cancer Mortality in Norway. Kalager M, Zelen M, Lanmark MD, Adam H-O. N Engl J Med 2010;363:1203-10.

Effects of mammography screening on surgical treatment for breast cancer in Norway. Suhrke P, Maehlen J, Schlichting E, Jorgensen KJ, Gotzsche P C, Zahl P-H. BMJ 2011; 343:d4692 7 July 2011 (accessed 9 October 2011)

An Investigation of the Apparent Breast Cancer Epidemic in France: screening and incidence trends in birth cohorts.  Junod B, Zahl P-H, Kaplan R M, Olsen J, Greenland S. BMC Cancer 2011, 11:401

Breast cancer incidence and over-diagnosis in Catalonia (Spain)’. Martinez-Alonso et al. Breast Cancer Research 2010.12R58. 

Breast cancer screening. Table 1: Harms of screening mammography. Questions about cancer.  National Cancer Institute at the National Institutes of Health. (accessed 9 October 2011)

US breast cancer mortality is consistent with European data. Bleyer A.             bmj 2011/343:d5630

The Breast screening programme and misinforming the public. Gotzsche Peter C, Jorgensen KJ. JR Soc J R Soc Med September 2011 vol. 104 no. 9 361-369

Breast screening: the facts – or maybe not. Peter Gotzsche et al. BMJ 2009; 338:b86

Still awaiting screening facts. M Baum, Hazel Thornton, Peter Gotzsche. 2 November 2010. 

Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database. Autier P, Boniol M, LaVecchia C, et al. BMJ 2010;341:3620

Breast cancer mortality in neighbouring European countries with different levels of screening but similar access to treatment: trend analysis of WHO mortality database. Autier P et al. BMJ 2011; 343:d4411

Prone to  Error; earliest steps to find cancer. Stephanie Saul. New York Times:

Goldman D, Jena AB, Lakdawalla D, Philipson T, Reyes C, Sun E. An economic evaluation of the war on cancer.  11 January 2010.

Should we use total mortality rather than cancer specific mortality to judge cancer screening programmes? No. Steele R JC, Brewster DH. BMJ 2011; 343:d6397 doi: 10.1136/bmj.d6397 (Published 13 October 2011)

Should we use total mortality rather than cancer specific mortality to judge cancer screening programmes? Yes. Penston, J. BMJ 2011; 343:d6395

Response: Cancer specific mortality is biased in breast screening trials – Peter C Gotzsche, Director, Nordic Cochrane Centre


Information about screening: is it to achieve high uptake or to ensure informed choice? Angela E. Raffle FFPHM Consultant in Public Health Medicine, Avon Health Authority, King Square House, Bristol, UK

Health Expectations Volume 4, Issue 2, Article first published online: 20 DEC 2001


Margaret McCartney’s blog

Call for a judicial review of the breast screening programme and for an independent body of people to write the information offered to women. (The Sunday Times, 31 July 2011, M Baum et al)

Let’s get frank about breast screening. Cornelia Baines

Breast Screening Controversy. M Baum, Letters pager, The Times Newspaper, 2 September 2011.

Breast screening should be scrapped. Evidence points to the fact that cancer mortality rates are dropping due to improved treatment, not mammograms. Professor M Baum. The Guardian Newspaper


No more mammograms for me By Veneta Masson

Special to The Washington Post, Tuesday, October 12, 2010; E1

In full

‘No Mammo?’ – Rachel Campergue, preface Dr Bernard Junod. Published 29 September 2011 – Max Milo. (French)

Books, booklets, leaflets

Cochrane leaflet: Screening for breast cancer with mammography


Breast beating. A personal odyssey in the quest for an understanding of breast cancer the meaning of life and other easy questions` M Baum. Anshan, 2010.


Testing treatments: better research for better healthcare. (Imogen Evans, Hazel Thornton, Iain Chalmers) – reprint by Pinter and Martin 2010 – or download it from the James Lind Library website (


Should I be tested for cancer? Maybe not and here’s why. H Gilbert Welch University of California Press, 2004. ISBN 0520239768

‘Smart Health Choices – making sense of health advice’, by Irwig, Irwig, Trevena and Sweet  – freely accessible online – to read or to download. PDFs are available for downloading under each section: 

*COCHRANE LEAFLET: screening for breast cancer with mammography

Health Knowledge website – Over-detection in breast screening is in chapter 2, Thornton, M Baum et al, letter, The Times Newspaper, 19 February 2009

‘Making Sense of Screening’ freely downloadable booklet.

NHS breast screening. NHS Cancer Screening Programmes. Department of Health in association with NHS Cancer Screening Programmes. 2010. (Tel 0300 123 1002 quote: 403722/Breast Screening.) (accessed 9 October 2011).





About bmitzi

Medical writer, author, artist. Cancer campaigner. Aiming always to improve health services and bring compassion into health care.
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3 Responses to Screening mammography: research references and links

  1. Marcel L. says:

    Very good list! Perhaps you should consider to include the independent treatise “The Mammogram Myth” by Rolf Hefti.

    • bmitzi says:

      Thank you – I will take a look… Of course much water has flowed, including Marmot report, which did not go far enough, and now the Parliamentary Inquiry is looking at screening programmes – (PLEASE NOTE responses sought!)

      Have you noticed the new campaign – BBC news yesterday – putting pressure on women 70 plus to attend the extended age screening – which Mike Richards called ‘the largest randomised controlled trial (RCT) in the world (bmj) – playing on women’s fear of cancer, especially vulnerable older women – and not even a mention of the appalling harms/risk of unnecessary treatment including huge risk of mastectomy, lack of benefit (Marmot report) – or that there is no informed consent – talk about unbiased reporting and ‘balanced’ advertising. I guess there has not been sufficient uptake of the RCT screening offer and they need enough older women guinea pigs to make it viable.

    • bmitzi says:

      Yes, I did see this, thank you:

      The latest hype on TV about screening women who are 70+ also talked about ‘no need to die, get it early and it can be treated’ etc – when they should be exposing the unnecessary harms and the fact that catching breast cancer early does not necessarily mean that life will be saved – clinicians’ and researchers’ understanding of breast cancer has moved on since those days. The gist of it is, aggressive cancers are most likely to pop up between screenings and go on to kill, while other changes, sometimes wrongly labelled ‘cancer’, could well cause no problems in lifetime.
      Of course there are many MANY vested interests in keeping screening programmes going.

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