Source: BBC Health; Journal of Medical Screening
Still think screening for breast cancer doesn’t matter? In this country there is a lot of debate about that very topic. Opponents of screening suggest that it results in over-treatment for “lumps” that may be benign cysts or nothing at all. What is over-treatment? Sometimes simple referral for ultrasound or MRI and sometimes referral to a breast surgeon for aspiration (withdrawing cells through a needle), biopsy (cutting out a portion of the lump) or excision (removal of the lump).
Well the latest study, out of England, focused upon 80,000 women aged 50 and over. (Women in England between 50 and 70 receiving screening every 3 years under the National Health System). The results? Over a period of 20 years, 5.7 (yeah, I don’t know what a .7 person is either) breast cancer deaths were prevented for every 1,000 women screened. 2.3 of those 1,000 women were told they had a lump of unclear significance. Okay, that’s raw numbers, what does it mean? Well, for every 28 cases diagnosed, 2.5 women had their lives saved and 1 woman was over-diagnosed.
According to the authors of the study, “The benefits in terms of numbers of deaths prevented are around double the harm in terms of over-diagnosis.” Projecting forward leads them to believe that, “A significant reduction in breast cancer deaths in association with mammographic screening.”
Because of research such as this the NHS plans to extend mammography to women 47 to 73 by 2012. Meanwhile, here in the United States and with the possible implementation of a National Health Care Service we appear to be going in the opposite direction. Here we debate the costs of screening women under 50. Whether or not it’s prudent. Economically effective. And whether or not too much screening, rather than resulting in more diagnosis and lives saved, results in over-treatment (read more money).
And back across the pond, a spokesperson for Cancer Research UK, Sara Hiom, was quoted saying, “What we need to remember is that detecting cancers earlier generally means improved survival. And we know through trials and through research that breast cancer screening can save lives.”
Deputy Directer of the NHS cancer screening programmes (thats Brit for programs) adds, “There is a risk of over-diagnosis and possible subsequent over-treatment associated with any screening programme” and that, “The latest independent study shows that the risk of over-diagnosis is very much lower than some other recent estimates have claimed and that the benefits [of mammography screening] far outweigh the risks.” Well put.
~Posted by D.M. Schwadron, Esquire