NHS breast screening programme

BMJ 1999;318:397 ( 6 February )

Letters

NHS breast screening programme

Both extended age range and reduced screening interval are needed

Money may be better spent on symptomatic women

Growth rate is more important than size

Modelling is suspect, and results lack confidence intervals

Authors' reply

Both extended age range and reduced screening interval are needed

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

EDITOR $---$ "The cure for breast cancer," said the American breast surgeon Susan Love, "is political action." ¹ There couldnot have been a clearer illustration of this point than the recentpapers about breast cancer screening.^2-4 Unfortunately, the authorsdo not estimate the cost of implementing both strategies for improvingthe breast screening service $---$ that is, both extending the age rangeand reducing the screening interval to two years $---$ but it seemsthat both policies will save lives and cost relatively little.Interval cancers tend to be faster growing and more life threatening,⁵and older women do respond to screening invitations.⁴ The questionshould not be "Which is the best policy?" ³ but "How soon canwe implement bothpolicies?"

In Australia, where free screening is provided from age 50 upwards at two yearly intervals and the life time risk of breastcancer is 1 in 11, mortality is only 28% of the current . . . [Full text of this article]

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