NHS spells out breast cancer screening risks

NHS spells out breast cancer screening risks  Revised leaflet sent to women invited for screenings contains more detail about overdiagnosis and unnecessary treatment

Women invited for breast cancer screening are being told more about the risks involved, despite fears that candour about the possibility of being wrongly diagnosed could discourage some from attending.

The letter and leaflet which women who are invited for screening receive have been overhauled, and give much more detail about the risk of overdiagnosis and unnecessary treatment.

The NHS has made the changes after growing controversy about the value of the procedure. Some experts claim the potential harm, including deaths from the long-term negative effects of unnecessary treatment, outweigh the estimated 1,300 lives a year saved by screening women aged 50-70.

The previous leaflet included five short paragraphs on "the downsides of being screened", which included exposure to radiation, the possibility of a false negative or false positive result and that the screening "can find cancers which are treated but which may not otherwise have been found during your lifetime".

By contrast, three pages of its 12-page successor highlight "the possible benefits and risks of breast screening", pointing out that "screening saves about one life from breast cancer for every 200 women who are screened", a total of about 1,300 lives a year.

But it also says that "about three in every 200 women screened every three years from the age of 50 to 70 are diagnosed with a cancer that would never have been found without screening and would never have become life-threatening. This adds up to about 4,000 women each year in the UK who are offered treatment they did not need."

Professor Julietta Patnick, director of the NHS cancer screening programme, said the leaflet "gives a more detailed explanation of the benefits and risks than previous versions. It provides a balanced assessment which will support women as they decide whether or not to attend their screening appointment."

While breast cancer charities welcomed the move, Mia Rosenblatt, head of policy and campaigns at Breast Cancer Campaign, said it was important that women "are presented with the key facts about screening". But, she added: "However this brings with it the potential that some women will be concerned as a result of this new focus on over diagnosis. This may have an impact on screening attendance." Screening take-up now be monitored for any potential fall and all women should attend appointments, she added.

In 2011-12 a total of 2.53m women in England were invited, including some aged 45 due to their family history of the disease. In all 73.1% of those aged 50 to 70 attended – some 1.94m in all – which was a slight proportionate fall on previous years. Cancer was detected in 8.1 of every 1,000 women screened, or 15,749 in all, and was most common (13.9 per 1,000 women screened) in those over 70.

Sir Michael Marmot, professor of epidemiology at University College London and the author of a major review last year which concluded that screening saves lives, said: "However, tThere are potential risks as well as benefits associated with breast screening, and it is important women are given information that is clear and accessible before they go for a mammogram."  Guardian