BMJ 1995;310:1002 (15 April)

Letters

Screening for breast cancer

Recommendations are costly and short sighted

EDITOR,--S Field and colleagues' recommendations for two view mammography, a shorter screening interval, double reading of films, training for staff, and a change in the density of the films are costly, short sighted proposals in human and economic terms.1

They are an attempt to address the emerging inadequacies of a programme of dubious value in terms of the primary objective, which is to reduce morbidity and mortality from breast cancer for all women. Ciaran B J Woodman and colleagues' paper highlighting the increased occurrence of interval cancers (but excluding in situ disease)2 coincides with Hakoma et al's report suggesting that cancers detected by screening are less aggressive and that the reduction in mortality may therefore be less than expected.3

Distributive justice demands that before more money is poured into the NHS breast screening programme we should consider the wider public health implications.4 The current . . . [Full text of this article]


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Relevant Article

What should be done about interval breast cancers?
S Field, M J Michell, M G W Wallis, and A R M Wilson
BMJ 1995 310: 203-204. [Extract] [Full Text]

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