Review underway into NHS breast screening

26th October 2011 - An independent review of the breast cancer screening programme has been called over claims that the NHS exaggerates its benefits and downplays the risks.

The review will be led by the national cancer director for England, Professor Mike Richards, who said he was taking the "current controversy very seriously".

He announced his decision to examine the evidence in the wake of an open letter from Professor Susan Bewley, Consultant Obstetrician at King's College London, who said that claims that 1,400 lives were saved each year because of screening have "not been subjected to proper scrutiny".

Telling the truth?

Professor Bewley wrote last month that she had compared information leaflets published by the NHS with those of the Nordic Cochrane Centre, an independent research and information establishment in Denmark, and found that "the NHS breast screening programme was not telling the whole truth".

She continued: "The distress of overdiagnosis and decision making when finding lesions that might (or might not) be cancer that might (or might not) require mutilating surgery is increasingly being exposed."

Saving lives

Women in the UK aged between 50 and 70 are invited for breast cancer screening. Although the process saves lives, it is not possible to say how many. According to Cancer Research UK, the figure is thought to be between 300 and 1,400 each year.

The downside of a screening programme is that it can lead to over-treatment, with some scientists estimating that for every woman whose life is saved by breast cancer screening, 10 women are treated unnecessarily.

Anxiety

Also, some women can receive false negative or false positive results. Women whose screening test is positive face unnecessary anxiety as they await further tests to decide whether or not they have breast cancer.

Professor Bewley said that she had taken the decision not to undergo breast cancer screening, despite a family history of the disease and other risk factors.

Responding in a letter to the BMJ, Professor Richards says that eight leading international scientists have agreed that the benefit of screening outweighs the risks of overdiagnosis and that an estimated two to two-and-a-half lives are saved for every overdiagnosed case of breast cancer.

Review underway

Announcing his review, which will be conducted with the help of Cancer Research UK, Professor Richards says he is "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".

Commenting on the review, Sara Hiom, director of information at Cancer Research UK, says in a statement: "We mustn't lose sight of the fact that the fundamental principle underpinning screening - that earlier diagnosis helps improve outcomes - is right and that screening does help save lives."

Dr Emma Pennery, clinical director at Breast Cancer Care says in a statement: "We know from calls to our helpline that conflicting opinions about screening can be confusing for people and adds to their anxiety, so we welcome an independent review which aims to find consensus."