Review launched into doubts over breast screening

The review, announced by the Government’s cancer tsar Professor Sir Mike Richards, follows criticism from some experts that NHS chiefs exaggerate the value of the programme and do not spell out potential risks.

The move has been welcomed by support groups which say it will resolve doubts over the programme – although they stress women should continue to attend appointments.

Official guidance suggests the programme, which screens around 1.5 million women annually and detects 14,000 cancers, saves 1,400 lives a year.

But in an exchange of letters in the British Medical Journal, consultant obstetrician Prof Susan Bewley, of King’s College London, said she agreed with experts in Scandinavia who have criticised screening for leaving thousands of women to undergo potentially devastating but unnecessary treatment due to over-diagnosis.

She claimed NHS leaflets “exaggerated benefits and did not spell out the risks” of screening and demanded an independent review that would not be “kicked into the long grass”.

“The oft repeated statement that ‘1,400 lives a year are saved’ has not been subjected to proper scrutiny,” she added. “In the past few years, British women have not been told about the genuine doubts.

“I am not convinced that you have challenged your experts competently and mercilessly, rather than hidden behind them.”

In his reply, Prof Richards said he believed screening programmes should be based on the best available evidence and current advice, including from the World Health Organisation, was that breast screening savesd lives and the benefits considerably outweighed the harms.

But he agreed “the ongoing controversy should, if at all possible, be resolved”.

He said he had launched an independent review of research and a new process for developing written information for the public about each cancer screening programme was being established.

“Should the independent review conclude that the balance of harms outweighs the benefits of breast screening, I will have no hesitation in referring the findings to the national screening committee and then Ministers,” he writes.

“You also 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.”

Emma Pennery, clinical director at Breast Cancer Care, said: “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.”

Chris Askew, chief executive of Breakthrough Breast Cancer, said breast screening was vital in detecting cancer at its earliest stages when no other symptoms were obvious.

“The current debate over the pros and cons of screening may be very confusing for women and so we welcome this review. We hope it will mean women are reassured that all the evidence has been considered and the information they receive is accurate and balanced,” he said.

A Department of Health spokesman said it would examine the findings of the review.

He added: “Our advice has not changed – we urge all women to go for breast screening when invited. The best available evidence shows that screening saves lives by detecting cancers earlier than they would otherwise have been.”