Extending the benefits of breast cancer screening

BMJ 1998;317:360-361 ( 8 August )

Editorials

Extending the benefits of breast cancer screening

Still hard to know how large the benefits will really be

Papers pp 376 , 388

The first 150 words of the full text of this article appear below.

Ever since the implementation of the NHS breast screening programme in 1988 two important questions have been consistentlyraised. Should the age range of women invited be extended fromthe current range of 50-64 years, and should the screening intervalbe reduced from the current three years? If we are to believe the cost effectiveness analysis by Boer et al in this week's issue(p 376),¹ an increase in age to 69 and a two year interval would each generate substantial benefits in life years saved anddeaths averted $---$ but, needless to say, at a substantial cost. Moreover,the authors' conclusion that extending the age range is expectedto prevent more deaths, whereas shortening the screening intervalwould save more life years leaves policymakers with a $---$ not unfamiliar $---$ ethicaldilemma.

It is obviously desirable to improve life expectancy in those women already eligible for screening. Reducing the intervalcancer rate, which is particularly high . . . [Full text of this article]

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Goodare, H., King, M., Baum, M., Johnson, A., Shekhdar, J., Day, N E, Boer, R., de Koning, H., Threlfall, A., Woodman, C., Street, A., Friedman, E. (1999). NHS breast screening programme. BMJ 318: 397a-397 [Full text]
Rubin, G, Garvican, L. (1998). Breast cancer screening: false positive rate is lower in older women. BMJ 317: 599-599 [Full text]