The latest information provided by the NHS Breast Screening Programme (NHS BSP) continues to misinform, say the authors of a report published in the Journal of the Royal Society of Medicine.
The paper, The Breast Screening Programme and Misinforming the Public by Professor Peter C Gøtzsche and Karsten Juhl Jørgensen of the Nordic Cochrane Centre, calls for more honesty from the NHS BSP. It argues that harm has been downplayed and that the information provided for the public has remained largely unaffected by repeated criticism and pivotal research which has questioned the benefits of screening and documented substantial over-diagnosis. The paper states that information regarding lives saved through the screening programme is exaggerated. “The claim that death rates have fallen ‘in part from earlier diagnosis associated with screening’ is astonishingly misleading,” said Prof. Gøtzsche, co-author of the paper and director of the Nordic Cochrane Centre. “Deaths from breast cancer are falling because treatment is improving. There has been a similar fall in the age-groups not invited to screening. Gøtzsche and Jørgensen argue that the Programme’s estimate that screening prevents one breast cancer death for every 400 women screened regularly over ten years is wrong by a factor of five. The paper also argues that the NHS BSP had provided contradictory information about over-diagnosis. “The (2010) Review has reverted to repeating the too-low estimate regarding over-diagnosis from the 2006 Review, but it is obscure as to where this figure comes from. The new leaflet never uses the term over-diagnosis, and although it talks a lot about benefits it does not use the equivalent term ‘harms’ but just speaks about downsides, which is far less negative.” The authors criticise the Programme’s 2010 Annual Review for encouraging a belief that screening will reduce the chances of a woman having to have a mastectomy by using sentences such as ‘If a breast cancer is found early, you are less likely to have a mastectomy’. But such claims are seriously misleading, say the authors. “Danish data has demonstrated that because of over-diagnosis, screening increases the use of mastectomies substantially.”
