The Breast Screening Programme and Misinforming the Public

Overview

Journal J R Soc Med

Specialty General Medicine

Date 2011 Sep 2

PMID 21881087

Citations 12

Authors

Peter C Gotzsche

Karsten Juhl Jorgensen

Affiliations

Soon will be listed here.

Abstract

The information provided to the public by the NHS Breast Screening Programme has been criticized for lack of balance, omission of information on harms and substantially exaggerated estimates of benefit. These shortcomings have been particularly evident in the various invitation leaflets for breast screening and in the Programme's own 2008 Annual Review, which celebrated 20 years of screening. The debate on screening has been heated after new data published in the last two years questioned the benefit and documented substantial harm. We therefore analysed whether the recent debate and new pivotal data about breast screening has had any impact on the contents of the new 2010 leaflet and on the 2010 Annual Review. We conclude that spokespeople for the Programme have stuck to the beliefs about benefit that prevailed 25 years ago. Concerns about over-diagnosis have not been addressed either and official documents still downplay this most important harm of breast cancer screening.

Citing Articles

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A Review and Comparative Analysis of Information Targeted to the General Public on the Websites of Breast Screening Programs in Canada.

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References

Gotzsche P, Nielsen M . Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2009; (4):CD001877. DOI: 10.1002/14651858.CD001877.pub3. View

Duffy S, Tabar L, Olsen A, Vitak B, Allgood P, Chen T . Absolute numbers of lives saved and overdiagnosis in breast cancer screening, from a randomized trial and from the Breast Screening Programme in England. J Med Screen. 2010; 17(1):25-30. PMC: 3104821. DOI: 10.1258/jms.2009.009094. View

Jorgensen K, Zahl P, Gotzsche P . Breast cancer mortality in organised mammography screening in Denmark: comparative study. BMJ. 2010; 340:c1241. PMC: 2844939. DOI: 10.1136/bmj.c1241. View

Nystrom L, Rutqvist L, Wall S, Lindgren A, Lindqvist M, Ryden S . Breast cancer screening with mammography: overview of Swedish randomised trials. Lancet. 1993; 341(8851):973-8. DOI: 10.1016/0140-6736(93)91067-v. View

Esserman L, Shieh Y, Thompson I . Rethinking screening for breast cancer and prostate cancer. JAMA. 2009; 302(15):1685-92. DOI: 10.1001/jama.2009.1498. View

. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005; 365(9472):1687-717. DOI: 10.1016/S0140-6736(05)66544-0. View

Blanks R, Moss S, McGahan C, Quinn M, Babb P . Effect of NHS breast screening programme on mortality from breast cancer in England and Wales, 1990-8: comparison of observed with predicted mortality. BMJ. 2000; 321(7262):665-9. PMC: 27479. DOI: 10.1136/bmj.321.7262.665. View

Rostgaard K, Vaeth M, Rootzen H, Lynge E . Why did the breast cancer lymph node status distribution improve in Denmark in the pre-mammography screening period of 1978-1994?. Acta Oncol. 2010; 49(3):313-21. DOI: 10.3109/02841861003602074. View

Jorgensen K, Keen J, Gotzsche P . Is mammographic screening justifiable considering its substantial overdiagnosis rate and minor effect on mortality?. Radiology. 2011; 260(3):621-7. DOI: 10.1148/radiol.11110210. View

10.

Thornton H, Edwards A, Baum M . Women need better information about routine mammography. BMJ. 2003; 327(7406):101-3. PMC: 1126456. DOI: 10.1136/bmj.327.7406.101. View

11.

Morrell S, Barratt A, Irwig L, Howard K, Biesheuvel C, Armstrong B . Estimates of overdiagnosis of invasive breast cancer associated with screening mammography. Cancer Causes Control. 2009; 21(2):275-82. DOI: 10.1007/s10552-009-9459-z. View

12.

Gotzsche P, Hartling O, Nielsen M, Brodersen J, Jorgensen K . Breast screening: the facts--or maybe not. BMJ. 2009; 338:b86. DOI: 10.1136/bmj.b86. View

13.

Berg W . Benefits of screening mammography. JAMA. 2010; 303(2):168-9. PMC: 3891888. DOI: 10.1001/jama.2009.1993. View

14.

Autier P, Boniol M, La Vecchia C, LaVecchia C, Vatten L, Gavin A . Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database. BMJ. 2010; 341:c3620. PMC: 2920378. DOI: 10.1136/bmj.c3620. View

15.

Jorgensen K, Gotzsche P . Content of invitations for publicly funded screening mammography. BMJ. 2006; 332(7540):538-41. PMC: 1388137. DOI: 10.1136/bmj.332.7540.538. View

16.

Gotzsche P, Jorgensen K, Zahl P . Breast screening: why estimates differ by a factor of 20-25. J Med Screen. 2010; 17(3):158-9. DOI: 10.1258/jms.2010.010066. View

17.

Autier P, Boniol M, Middleton R, Dore J, Hery C, Zheng T . Advanced breast cancer incidence following population-based mammographic screening. Ann Oncol. 2011; 22(8):1726-35. PMC: 3144633. DOI: 10.1093/annonc/mdq633. View

18.

Mayor S . Critics attack new NHS breast screening leaflet for failing to address harms. BMJ. 2010; 341:c7267. DOI: 10.1136/bmj.c7267. View

19.

Jorgensen K, Gotzsche P . Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends. BMJ. 2009; 339:b2587. PMC: 2714679. DOI: 10.1136/bmj.b2587. View

20.

Humphrey L, Helfand M, Chan B, Woolf S . Breast cancer screening: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002; 137(5 Part 1):347-60. DOI: 10.7326/0003-4819-137-5_part_1-200209030-00012. View