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Breast screening 'benefits outweigh harms'
Source: Agencies |
September 14, 2012, Friday
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BREAST screening programs in Europe save more lives by catching tumors early than they harm through over-diagnosis and women should be made more aware of benefit-risk balance, researchers said yesterday.
In the first comprehensive review of European breast cancer screening programs, scientists found that for every 1,000 women aged 50 to 69 screened every two years, between seven and nine lives are saved.
But in a finding likely to add to an already fierce international debate about the merits of routine screening for cancer, they also found that in the same group, four women would be "over-diagnosed" - when screening picks up a tumor that would never have presented a problem.
Stephen Duffy, professor of cancer screening at Queen Mary, University of London and one of two lead researchers on the study, said the harm caused by over-diagnosis in the few women was clearly outweighed by the reduction in cancer deaths.
"(This review) reports results from screening millions of women, and confirms that the screening services are delivering the benefits expected from the research studies conducted years ago," he said.
"In particular it is good news that lives saved by screening outweigh over-diagnosed cases by a factor of two to one."
Over-diagnosed breast cancers are tumors diagnosed during screening which would never have given rise to any symptoms during a woman's lifetime and would not have been diagnosed had she not been screened.
That can lead to women undergoing unnecessary and invasive treatment and suffering the physical and psychological impact of a breast cancer diagnosis that would otherwise not have come up.
The researchers also found that for every 1,000 women screened, 170 women would have at least one recall for a non-invasive assessment before a negative result could be confirmed, and 30 women would have at least one recall for an invasive procedure, such as a biopsy, before getting a negative result.
These types of results are called "false positives" and can cause stress and anxiety until a negative result is confirmed.
The issues of over-diagnosis and false positives were at the heart of rows among cancer patients and specialists in Europe and the United States which blew up in 2009 when American health officials questioned the value of routine mammograms for women at age 40 and suggested raising the annual screening age to 50.
Nordic scientists then published a study in 2010 which found no evidence that screening women for breast cancer has any effect on death rates.
In the first comprehensive review of European breast cancer screening programs, scientists found that for every 1,000 women aged 50 to 69 screened every two years, between seven and nine lives are saved.
But in a finding likely to add to an already fierce international debate about the merits of routine screening for cancer, they also found that in the same group, four women would be "over-diagnosed" - when screening picks up a tumor that would never have presented a problem.
Stephen Duffy, professor of cancer screening at Queen Mary, University of London and one of two lead researchers on the study, said the harm caused by over-diagnosis in the few women was clearly outweighed by the reduction in cancer deaths.
"(This review) reports results from screening millions of women, and confirms that the screening services are delivering the benefits expected from the research studies conducted years ago," he said.
"In particular it is good news that lives saved by screening outweigh over-diagnosed cases by a factor of two to one."
Over-diagnosed breast cancers are tumors diagnosed during screening which would never have given rise to any symptoms during a woman's lifetime and would not have been diagnosed had she not been screened.
That can lead to women undergoing unnecessary and invasive treatment and suffering the physical and psychological impact of a breast cancer diagnosis that would otherwise not have come up.
The researchers also found that for every 1,000 women screened, 170 women would have at least one recall for a non-invasive assessment before a negative result could be confirmed, and 30 women would have at least one recall for an invasive procedure, such as a biopsy, before getting a negative result.
These types of results are called "false positives" and can cause stress and anxiety until a negative result is confirmed.
The issues of over-diagnosis and false positives were at the heart of rows among cancer patients and specialists in Europe and the United States which blew up in 2009 when American health officials questioned the value of routine mammograms for women at age 40 and suggested raising the annual screening age to 50.
Nordic scientists then published a study in 2010 which found no evidence that screening women for breast cancer has any effect on death rates.
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