Breast screening glitch – the facts

The computer glitch that resulted in women not being offered breast screening means they are more likely to have avoided unnecessary treatment than to have had their lives put at risk. The breast screening review by Sir Michael Marmot concluded harms outweighed benefits by 3 to 1 – and that did not even include all-cause mortality. Deaths from treatments seem to be ignored – and although overdiagnosis and overtreatment are now acknowledged harms, the general public seem to be unaware of the scale of these harms and think the only risk is radiation. And how many women who are being invited to screening as part of the extended programme realise these harms – and that they are being asked to take part in the largest ever randomised controlled trial – AgeX – without any consent process?

Let’s hope this letter in today’s The Times raises awareness and women begin to understand that breast screening is not the life saver it was originally thought to be. But how to stop a Juggernaut?

‘Catching some things that look like cancer down a microscope (before it exists) can be too early’

‘The most dangerous advanced cancers are not prevented by screening programmes’

‘The breast screening programme mostly causes more unintended harm than good’

‘Many women and doctors now avoid breast screening because it has no impact on all-cause death’

‘Claims of lives ‘saved’ are counteracted by deaths resulting from interventions’

‘The breast screening programme has been slow to tell women the full truth’

‘Women are entitled to accurate, understandable information about health’

Susan Bewley, professor of women’s health, KCL; Michael Baum, professor emeritus of surgery, UCL; other signatories including those of more doctors can be found at thetimes.co.uk/letters

See also: https://www.healthwatch-uk.org/ – the charity that has been promoting science and integrity in healthcare since 1991.

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Posted in Breast Cancer, breast screening, Campaigns, cancer, citizen safety, clinical trials, Compassion in healthcare, death, diagnoses, harms, healthcare modernisation, information, informed consent, mastectomy, medicine's flaws, Over-medicalisation, overdiagnosis, overtreatment, patient/doctor communication, personal autonomy, Public safety, Screening, Screening Mammography, speaking out | Tagged , , , , | Leave a comment

CPD accredited Nothing Personal, disturbing undercurrents in cancer care

Ideal for Continuing Professional Development and medical education at all levels: ‘This is a beautifully written book, styled in a natural mix of prose, poetry and discussion points, which provides a rare insight into the thoughts of someone who can express their innermost perceptions and feelings…The most important lesson for me is that we need to continually develop and improve our understanding and skills of how to communicate better, more honestly and with real regard for our patients’ intelligence and dignity. This remarkable book…should be on the essential reading list for those striving to improve the quality of care for cancer and to understand and improve the experience of their patients more generally.’
–Professor A Niroshan Siriwardena, Quality in Primary Care 2009;17.

Posted in anal cancer, biopsies, books, Campaigns, cancer, cancer drugs, citizen safety, clinical trials, Compassion in healthcare, complaint, CPD accreditation, diagnoses, harms, healthcare modernisation, humour, information, informed consent, medicine's flaws, multidisciplinary team meetings (MTDs), nhs staff, openness, patient safety, patient/doctor communication, patient/public involvement, personal autonomy, poetry, Primary care, Public safety, rarer and uncommon cancers, speaking out | Tagged , , , , , , , , , , | Leave a comment

Nothing personal – now CPD accredited

‘If anyone is in any doubt of the need to take a more patient-centred approach to dealing with patients then they should read this.’ — Dr Eric Watts, The Bulletin of The Royal College of Pathologists, Number 144 – October 2008.

When I wrote Nothing Personal, disturbing undercurrents in cancer care, it was with the hope that lessons would be learned so that no other patients would suffer as I had. This was not intended to be just another ‘how it was for me’, so after each event there are discussion sections with research links to better/evidence-based practice. I am grateful for the amazing acceptance shown by so many healthcare professionals, but sadly improvements are piecemeal (https://www.gponline.com/i-shout-scream-beg-help-gps-ordeal-nhs-hospital-patient/article/1458217). As more pressure is put on NHS staff, how can we expect improvements to happen – and what is it like for them, working in such an environment? Dr Robin Youngson became one of my star heroes when he started a movement calling for compassion for professionals as well as patients (Hearts in Healthcare – https://heartsinhealthcare.com/) which shows what is needed and just how to achieve it.

Posted in anal cancer, books, Campaigns, cancer, citizen safety, clinical trials, Compassion in healthcare, complaint, CPD accreditation, harms, healthcare modernisation, humour, information, informed consent, medicine's flaws, multidisciplinary team meetings (MTDs), nhs staff, openness, patient safety, patient/doctor communication, patient/public involvement, personal autonomy, poetry, Public safety, rarer and uncommon cancers | Tagged , , , , , , , , , | Leave a comment

CPD accredited: Nothing Personal, disturbing undercurrents in cancer care

‘…it was a bit of a departure to find myself sitting up in bed one night almost unable to put down ‘Nothing Personal’…I left ‘Testament of Youth’ languishing on the floor to read this book; a fitting tribute to a powerful piece written by another feisty lady who takes on the medics in the same way that Vera Brittain took on the Establishment…In short, this is a cracking read.’ Dr John Nottingham, ACP News, summer 2009.

Posted in anal cancer, biopsies, books, Breast Cancer, Campaigns, cancer, citizen safety, clinical trials, Compassion in healthcare, complaint, CPD accreditation, harms, healthcare modernisation, humour, information, informed consent, medicine's flaws, multidisciplinary team meetings (MTDs), nhs staff, patient safety, patient/doctor communication, patient/public involvement, personal autonomy, poetry, Public safety, rarer and uncommon cancers, speaking out | Tagged , , , , , , , | Leave a comment

CPD certification for Nothing Personal

Nothing Personal, disturbing undercurrents in cancer care, Radcliffe Publishing (CRC Press), Winner of the Medical Journalists’ Association Open Book Award 2009, now has CPD accreditation. While the story reads like a novel, with humorous sketches throughout, there are discussion sections after each event and research references to better and evidence-based practice.

‘This is a beautifully written book, styled in a natural mix of prose, poetry and discussion points, which provides a rare insight into the thoughts of someone who can express their innermost perceptions and feelings…The most important lesson for me is that we need to continually develop and improve our understanding and skills of how to communicate better, more honestly and with real regard for our patients’ intelligence and dignity. This remarkable book…should be on the essential reading list for those striving to improve the quality of care for cancer and to understand and improve the experience of their patients more generally.’
–Professor A Niroshan Siriwardena, Quality in Primary Care 2009;17.

Posted in anal cancer, biopsies, books, Breast Cancer, cancer, clinical trials, Compassion in healthcare, complaint, CPD accreditation, diagnoses, dying, harms, healthcare modernisation, humour, information, informed consent, medicine's flaws, multidisciplinary team meetings (MTDs), nhs staff, openness, patient safety, patient/doctor communication, patient/public involvement, personal autonomy, poetry, Primary care, Public safety, rarer and uncommon cancers, speaking out, Uncategorized | Tagged , , , , , , , , , | Leave a comment

Screening harms: why change is needed

Significant article on PSA screening echoes repeated findings on breast screening mammography, ie plenty of harms, but little effect on mortality.

Just as with breast screening, prostate cancer screening is controversial: ‘…potential mortality or quality-of-life benefits may be outweighed by harms from overdetection and overtreatment’.

The findings of this trial showed the effect of psa screening on prostate cancer mortality echoed similar conclusions from years of breast screening research on breast cancer mortality: ‘The single PSA screening intervention detected more prostate cancer cases but had no significant effect on prostate cancer mortality after a median follow-up of 10 years.’

‘The findings do not support single PSA testing for population-based screening’.

Are the potential harms of screening adequately explained to people invited to participate?

http://www.isrctn.com/ISRCTN92187251

Effect of Low-intensity PSA-Based Screening Intervention on Prostate Cancer Mortality. The CAP Randomized Clinical Trial.

Richard M Martin, Jenny L Donovan, Emma L Turner et al. JAMA. 2018;319(9):883-895

https://jamanetwork.com/journals/jama/article-abstract/2673968?redirect=true

Posted in Breast Cancer, breast screening, Campaigns, citizen safety, Compassion in healthcare, diagnoses, dying, harms, healthcare modernisation, information, informed consent, medicine's flaws, Over-medicalisation, overdiagnosis, overtreatment, prostate cancer, Public safety, Screening, Screening Mammography, screening prostate cancer | Tagged , , , , | Leave a comment

Breast screening, cancer treatments and cardiovascular disease

This article highlights serious risks to cardiovascular health caused by breast cancer treatments (which need to be considered as part of overdiagnosis and overtreatment due to breast screening mammography).

‘…current breast cancer treatments can have a negative impact on cardiovascular health (eg, left ventricular dysfunction, accelerated CVD) …’ ‘For older women, CVD poses a greater mortality threat than breast cancer itself.’

‘Cardiovascular disease and breast cancer: where these entities intersect: a scientific statement from the American Heart Association’. Laxmi S Mehta et al. Circulation, February 6, 2018. Vol 137, Issue 6.

http://circ.ahajournals.org/content/early/2018/01/31/CIR.0000000000000556

Posted in Breast Cancer, breast screening, Campaigns, cancer, citizen safety, Compassion in healthcare, healthcare modernisation, informed consent, medicine's flaws, Over-medicalisation, overdiagnosis, overtreatment, personal autonomy, Public safety, Screening, Screening Mammography | Tagged , , , , | Leave a comment