The Swiss Medical Board (SMB) has published a report about mammographic screening in Switzerland (15 December 2013).
They report: on the basis of the existing literature, the conclusion can be drawn that systematic mammography screening can contribute to the discovery of tumours at an earlier stage and the mortality rate from breast cancer can be reduced slightly by means of the screening.
However, ‘according to study data from the years 1963 to1991, of 1,000 women with regular screening, 1 to 2 fewer women die from breast cancer than 1,000 without regular screening.
This desirable effect is offset by the undesirable effects: Specifically, with about 100 of 1,000 women with screening, erroneous results are produced, which lead to further investigations and, in part, to unnecessary treatments.’
They add that the cost/effectiveness ratio is very unfavourable.
These are their recommendations:
1.It is not recommended that systematic mammography screening programs be.
2.A time limit is to be set on existing systematic mammography screening programs.
3.All forms of mammography screening are to be evaluated with regard to quality.
4.Likewise, for all forms of mammography screening, a previous thorough medical evaluation and a
comprehensible clarification with presentation of the desirable and undesirable effects are recommended
The Board’s summary in English can be found here:
NB There is currently a HoC parliamentary inquiry into screening programmes – and despite this, the harms v benefit ratio demonstrated by research, plus the Marmot Report – the Age Extension 70 plus breast cancer screening randomised controlled trial continues unabated – without written consent. Not only that, but there is now yet another screening campaign, this time aimed specifically at women aged 70 and over. Perhaps the public is getting wise to the fact that finding breast cancer early might mean it can be treated, but does not necessarily mean ‘your life will be saved’ – but only that by attending screening programmes you stand a 3 to 1 chance of overdiagnosis and overtreatment.
A sample of public opinion would probably show most people are in favour of such a screening programme – but then how many of them understand the issues in breast screening – and how many would give consent (if they were even offered it) simply because of the inadequate information that has always accompanied screening ‘invitations’.?