Breast cancer screening cannot be justified, says researcher

Book argues harm outweighs small number of lives saved, and accuses mammography supporters of misconduct

From The Guardian

Breast cancer screening can no longer be justified, because the harm to many women from needless diagnosis and damaging treatment outweighs the small number of lives saved, according to a book that accuses many in the scientific establishment of misconduct in their efforts to bury the evidence of critics and keep mammography alive.

Peter Gøtzsche, director of the independent Nordic Cochrane Collaboration, has spent more than 10 years investigating and analysing data from the trials of breast screening that were run, mostly in Sweden, before countries such as the UK introduced their national programmes.

Mammography screening: truth, lies and controversy, from Radcliffe Publishing, spells out the findings of the Nordic Cochrane group for laywomen, rather than for scientists.

The data, Gøtzsche has maintained for more than a decade, does not support mass screening as a preventive measure. Screening does not cut breast cancer deaths by 30%, it saves probably one life for every 2,000 women who go for a mammogram. But it harms 10 others. Cancerous cells that will go away again or never progress to disease in the woman’s lifetime are excised with surgery and sometimes (six times in 10) she will lose a breast. Treatment with radiotherapy and drugs, as well as the surgery itself, all have a heavy mental and physical cost.

“I believe the time has come to realise that breast cancer screening programmes can no longer be justified,” Gøtzsche said. “I recommend women to do nothing apart from attending a doctor if they notice anything themselves.”

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2 responses to “Breast cancer screening cannot be justified, says researcher

  1. Screening 2000 women will uncover 6 cancers. One those women would have died from other causes and one would have been cured regardless of screening. That leaves four. Save one of those, that is a 25% reduction in deaths, pretty close to the 30% reduction. Further complicating the data, there is no accounting for the skill of the radiologist interpreting the mammogram. Finally, the studies can all be considered obsolete with the FDA approval of tomosynthesis, a new form of mammography which reduces false positive exams by over 50% and increases the ability to find smaller cancers in all women.

    • Then G Taylor still agrees there is overdiagnosis. Most women will never get cancer in their lifetime; most screened women get no benefit whatsoever, only costs, because they have not got and will not get cancer. They go in for screening in hope of being one of those few who may have their life saved, but in order to be in the running for any benefit (if any and that is not proven, though people still assert that there is benefit in spite of studies showing there isn’t as well as studies showing there is) an individual has to take the risk (size contested) of being overdiagnosed. Some people want to avoid cancer treatment they do not need. Some screened people will have cancer treatment they do not need. Those eligible for screening are sent an invitation they didn’t ask for and information that misleads. They have a right to know, and a right to choose. That G Taylor thinks it a risk worth taking is fine for G Taylor, but no-one can make that evaluation on anyone else’s behalf. It is not dangerous to mind one’s own business, accept one’s mortality, including the possibility of death from breast cancer, since one will die of something, far more people die of heart disease for which there is no screening, and no-one can with confidence assert that death from breast cancer is more likely in the unscreened than the screened, and there is a price the screened pay, the vast majority, and maybe all of them, for nothing.

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