Breast screening info 'misleads'

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Women undergoing routine breast screening in the UK are being misled about the risks involved, warn a group of UK experts.

Invitation letters and leaflets do not tell the truth about the number of tests ending in unnecessary treatment, they write in The Times.

It comes after a report in the British Medical Journal found women are given one-sided information on screening.

The NHS Screening Programme said leaflets were being reviewed.

Signatories including Professor Michael Baum, emeritus professor of surgery at University College London, and Dr Paul Pharoah, a Cancer Research UK researcher at the University of Cambridge, said it was "imperative" that breast screening leaflets were rewritten.

The screening programme produces a variety of leaflets and has an extensive website to provide the information that women need to make an informed decision Julietta Patnick, NHS Breast Screening Programme

None of the invitations for screening come close to telling the truth and as a result women are being manipulated, albeit unintentionally, into attending, they wrote.

Up to half of all cancers that are found by screening, if left to their own devices, might not do any harm during the woman's natural lifespan.

But when detected by mammogram, the woman may then undergo unnecessary surgery, chemotherapy and radiotherapy, the letter said.

Omissions

The debate over the risks and benefits of screening has come to a head after researchers at the Nordic Cochrane Centre published an analysis online in the BMJ in January pointing out the shortcomings and omissions in the information on breast screening given to women in the UK.

They developed their own leaflet which includes the statistic that for every 2,000 women screened regularly for ten years, one will avoid dying from breast cancer.

At the same time, ten will be treated unnecessarily for an abnormality that might never cause them harm.

And about 200 healthy women will experience a false alarm, and as a result be put under potentially severe psychological strain.

Women need to know the facts in order to make a decision about whether or not to undergo screening, they said.

Julietta Patnick, director of the NHS Breast Screening Programme, said the leaflets were currently being reviewed and they were committed to helping women make informed choices about their breast screening invitation.

"Part of this is helping them assess the risks and the benefits of screening for breast cancer.

"The screening programme produces a variety of leaflets and has an extensive website to provide the information that women need to make an informed decision."

Professor Peter Johnson, Cancer Research UK's chief clinician, said the screening programme is still the best weapon in the early detection of breast cancer.

"The latest research suggests that the screening programme saves around 1,400 lives every year in England alone.

"Our research has found that screening has reduced breast cancer death rates by up to a quarter in women within the screening age range, while international research found that for every 500 women screened, one life will be saved."

But he added it was important not to be complacent and monitoring and improving the screening programme needs to continue.

Jeremy Hughes, chief executive of Breakthrough Breast Cancer, said screening allows early diagnosis and potentially less invasive treatment for breast cancer with improved prospects for patients.

"Unfortunately, we simply don't know enough to accurately predict a woman's risk of developing the disease.

"With one in nine women at risk of getting breast cancer it is important that all can access screening from age 50.

"Fuelling widespread public concern over screening programmes could result in a drop in take up, like that seen with the dispute over the MMR vaccination."