The breast screening review


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Harpal Kumar
Cancer Research UK, London, UK

Abstract

Over the past few years several research papers, evidence reviews and opinion pieces have been published which have suggested that the benefits of mammographic screening for breast cancer may have been overestimated and that the harms of breast screening relating to over diagnosis may have been underestimated. Several of these articles have received wide coverage in the mainstream media. Other researchers have published further evidence indicating that the benefits are significant and outweigh the harms.

Although the advisory committee on breast cancer screening, which advises ministers in England, remains convinced that the benefits of screening outweigh the harms, the recent criticisms need to be considered thoroughly in order to make recommendations on the future of the programme. Most importantly, women and their GPs need clear guidance and public concerns need to be allayed.

The national cancer director and the chief executive of cancer research UK therefore commissioned an independent review of the benefit and harms of breast screening in October 2011. The methodology adopted for the review is intended to ensure its independence and differs from previous reviews in the following respects:

  • The panel members, while being highly respected experts in their own fields, have never previously been involved in the delivery of breast screening, nor have they published any papers or articles on breast screening. The panel is chaired by Professor Sir Michael Marmot.
  • In addition to reviewing the extensive published evidence on breast screening, the panellists have held oral sessions to hear evidence and ‘cross-examine' witnesses who are known to be strongly supportive or strongly sceptical of breast screening or the way in which the breast screening programme is conducted in this country.

The national cancer director and the CEO of Cancer Research UK are not involved in any of the panel members' discussions, nor will they be involved in preparing the final report. The report is expected to be published in autumn 2012. The results of the Marmot review will be used for a new leaflet on breast screening.