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Breast Cancer Screening Cannot Be Justified, Says Researcher

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

23.01.2012 |The Guardian

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Sarah Boseley, health editor, The Guardian, 23 January 2012 - 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."

The book is published as a UK review of the evidence for breast cancer screening, triggered by the Nordic Cochrane group's publications in scientific journals, gets under way. In October, the cancer tsar Sir Mike Richards promised an independent investigation of the data. It will be chaired by Sir Michael Marmot and will include some eminent statisticians, none of whom have been involved in the breast screening controversy before.

Richards has promised to act on its findings. "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 UK national screening committee and then ministers," he wrote at the time

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