On 17 December 2013, MPs launched an inquiry into the scientific merits of national health screening programmes and whether calls for health screening to be extended to cover conditions such as prostate cancer, lung cancer and post-natal depression are based on solid science.
Chair of the Science and Technology Committee Andrew Miller MP stated:
“The NHS spends a significant amount of money on health screening and it is important that this is underpinned by good scientific evidence.
Thousands of women are screened for breast cancer every year and lives are saved as a result but there may also be women who undergo unnecessary treatment and surgery as a result of screening. Calls to extend screening to other conditions should ensure that there is good evidence that the screening would be effective.
We will be examining the evidence base behind the decisions on which illnesses to screen for and will be asking whether we are currently getting these decisions right in the UK.’ http://www.parliament.
It is somewhat disconcerting that the Chairman is reported as saying ‘there MAY also be women who undergo unnecessary treatment and surgery as a result of screening’ (above) when overdiagnosis and overtreatment are now established facts. Even the government’s own Independent Review of breast cancer screening found that women being screened regularly for breast cancer were three times more likely to be overdiagnosed and overtreated than to benefit – and even that benefit has been shown to be over-rated and doubtful as new understanding of breast cancer shows, sadly, that ‘finding it early’ does not necessarily mean your life will be saved, and aggressive cancers tend to pop up between screenings.
And what about the health checks that are currently bombarding healthy people – and the (played down?) risks these carry (see The Patient Paradox, by Margaret McCartney, GP, for insight into the medicalisation of well people).
Meanwhile here, in a nutshell, is what we do and don’t know about breast cancer screening:
‘Breast Cancer Screenings: what we still don’t know’, H Gilbert Welch, professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice and an author of “Overdiagnosed: Making People Sick in the Pursuit of Health.”
See also ‘Screening for Breast Cancer with Mammography’ from the Nordic Cochrane Research Centre: http://www.cochrane.dk/screening/mammography-leaflet.pdf
PLEASE SHARE WIDELY. Informed women can make an informed decision about whether or not to participate in breast screening (the mammography programme for women without breast symptoms – not to be confused with those who do have symptoms and so need investigations).