June 17, 2014

expert reaction to paper and editorial on breast cancer screening and mortality

A study published in the BMJ reported that inviting women for mammography screening may reduce breast cancer deaths by up to 28%. An accompanying editorial highlighted the need for greater patient understanding of possible harms, as well as benefits, of mammograms.

Prof Shirley Hodgson, Professor of Cancer Genetics, St George’s, University of London (SGUL), said:

“This is a carefully conducted and analysed prospective study of the breast cancer associated mortality in women who were being screened by two-yearly mammograms between the ages of 50 and 69 years in Norway. This study was conducted between 1995 and 2005, and clearly demonstrated a reduction in mortality by about 28% in screened women. The authors discuss possible confounding effects from the methodology and were very careful in their analysis to avoid misinterpretation. These results were similar to some other studies from Finland and Denmark, but there is considerable diversity in the outcomes from other studies and not all studies have shown such striking benefits. The editorial points out the considerable difficulties of achieving unbiased studies of this sort and the need to provide robust information to women undergoing screening because of the disadvantages of screening. These include the emotional effects of false positive results which can lead to unnecessary recall for further diagnostic tests, and the problem of misdiagnosis and unnecessary treatment in some cases.”

Declared interests

None declared