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Breast cancer screening review begins

A review into the evidence for breast cancer screening is underway to assess its effectiveness.

Controversy around breast cancer screening erupted amid claims it causes "more harm than good".

This conflicts with research from the World Health Organisation, which argues the measure reduces death by the disease by up to 35%.

Mike Richards, the National Clinical Director for Cancer and End of Life Care at the Department of Health, said he is "taking the controversy seriously".

In an open letter to Susan Bewley, Professor of Compex Obstetrics at King's College London, published in the British Medical Journal, Richards confirmed he will lead the review together with Harpal Kumar, Chief Executive at Cancer Research UK.

Last month, Bewley raised her concerns to Richards that the NHS breast screening programme "was not telling the whole truth".

She claimed NHS leaflets "exaggerated the benefits and did not spell out the risks".

In a letter to Richards, she also pointed to the "growing body of international opinion acknowledging the measure was not as good as used to be thought" and argues "the repeated statement that 1,400 lives a year are saved has not been subject to proper scrutiny".

"Trust is at stake if the public is not told the full story," she warned.

Responding to claims that false positives of breast cancer may cause psychological distress to women as a result of screening measures, Richards cited work undertaken by eight international scientists found an estimated two and a half lives are saved for every overdiagnosed case of breast cancer.

The researchers then concluded that the benefit of mammographic screening in terms of lives saved is greater than the harm in terms of overdiagnosis.

Richards said he will have "no hesitation" in referring the findings to the UK National Screening Committee and then ministers should the independent review conclude that the balance of harms outweighs the benefits of breast screening.

"You have my assurance that I am fully committed to the public being given information in a format that they find acceptable and understandable and that enables them to make truly informed choices," said Richards.

Chris Askew, Chief Executive of Breakthrough Breast Cancer, said the current debate over the pros and cons of screening is "very confusing" for women and as such welcomes the review.

"We believe that breast screening is vital as it can detect breast cancer at the earliest possible stages when no other symptoms are obvious," he said. 

"We hope [the review] will mean women are reassured that all the evidence has been considered and the information they receive is accurate and balanced.

Jack Kaye, CEO of Westhouse Medical Services, also welcomes the review, claiming the current programme is "expensive, based on outdated demographics, and testing is infrequent." 

"While the introduction of mammogram screening has undoubtedly saved many lives, they are also invasive, uncomfortable and may be inconvenient for women as they involve the patient travelling to a specialist centre if no mobile unit is available," he said.

Cancer Research UK

Your comments (terms and conditions apply):

"Yes without a doubt it's so important to have breast screening it only takes 10-15 mins it's not painful a little uncomfortable.I have been having breast screening undertaken for many years. I have had cancer seven years past endometrial cancer. I think breast screening must continue. I would like too see breast screening for younger age group as too many young girls have lost their lives" - Helen Shaw, Clydebank

"Yes, but I would also like to see other cancers given the high priority breast cancer receives, and I can assure you they are not" - Evelyn Jordan, Warwickshire

"The question is what is the chance screening will save your life versus generating harm, and is the programme cost effective? As time goes by it seems the answer is screening in it's current form would be rejected by most patients if they knew the truth about the low chance of benefit from screening" - David Ferry, Birmingham