‘Is routine breast screening doing more harm than good?’ asks Robin Bell, Professor & Deputy Director, Women’s Health Program, School of Public Health and Preventive Medicine at Monash University in The Conversation (Australia) 19 November 2012. See full article at:
Excerpts: An over-diagnosed case is one where screening has identified a breast cancer that will never cause harm.
As it is not currently possible to distinguish breast cancer identified through screening which will never cause harm from cancer that will, all breast cancer identified by screening is treated – with surgery and various combinations of radiotherapy, chemotherapy, endocrine and biologic therapies.
A woman treated needlessly will have no way of knowing that her cancer was harmless and that her well-being has been sacrificed, without her knowledge or consent, for the sake of others who may have benefited from screening.
The benefits of screening appear to have been over-estimated.
The Nordic Cochrane Center review of screening mammography has estimated the ratio of cases over-diagnosed to deaths from breast cancer prevented at 10:1. Our estimate of the ratio in Australia, using a lower estimate of deaths prevented due to the impact of improved treatment and the higher rate of over-diagnosis, is closer to 15:1.
The clear message is that over-diagnosis exists, it happens regularly as part of the screening process and women need to understand this.