How effective is screening for breast cancer?

doi:10.1136/bmj.321.7262.647

BMJ 2000;321:647-648 ( 16 September )

Editorials

How effective is screening for breast cancer?

Reductions in mortality should not be the only marker of success

Papers p 665

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

Many countries initiated national screening programmes for breast cancer after the results of the Swedish two counties trialwere published in 1985.¹ This trial, which took place in Kopparbergand Östergötland, found that mortality from breast cancer fellby 31% after seven years' follow up of women who had been aged40-74 at the beginning of the trial. These findings confirmedthe results of an earlier trial by Shapiro et al.² Finlandand Sweden started their programmes in 1986, the United Kingdomin 1988, and the Netherlands in 1989. Those in charge of healthpolicy in these countries now want evidence that these programmesare achieving theirgoals.

Can the results of randomised controlled trials be generalised, and can the impact be maintained when findings are put intopractice? The crucial point of this process is the setting ofthe goal, which for screening with mammography is usually a reductionin mortality from breast . . . [Full text of this article]

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Miller, A. B, Rozenberg, S., Carly, B., Liebens, F., Ham, H., Baum, M., Tobias, J S (2000). Effect of screening programme on mortality from breast cancer. BMJ 321: 1527a-1527 [Full text]