BMJ  2005;331:350-351 (6 August), doi:10.1136/bmj.331.7512.350-b

Letter

Model of outcomes of screening mammography

Information needs to support informed choices

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

EDITOR—Barratt et al report that for every 1000 women screened from the age of 50 over 10 years, two fewer will die from breast cancer and 13 more will be diagnosed with breast cancer (corresponding to 63% more cancers, which mostly constitute overdiagnosis).1 Similarly, we found that for every woman who has her life prolonged, five healthy women, who would not have received a breast cancer diagnosis in their lifetime if there had not been screening, will be converted into cancer patients unnecessarily.2

However, it is important to inform women that the often used estimate of 25-30% for the survival benefit is uncertain and rather optimistic.2 3 Barratt et al even used 37% since they adjusted their estimate of 25% for non-compliance. This procedure is doubtful since, as noted by two of the investigators in the screening trials, women who refuse to be screened have a worse prognosis, presumably . . . [Full text of this article]

Peter C Gøtzsche, director

pcg@cochrane.dk
Nordic Cochrane Centre, Rigshospitalet, Department 7112, Blegdamsvej 9, DK-2100 Copenhagen, Denmark

Karsten J Jørgensen, physician

Nordic Cochrane Centre, Rigshospitalet, Department 7112, Blegdamsvej 9, DK-2100 Copenhagen, Denmark


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Relevant Article

Model of outcomes of screening mammography: information to support informed choices
Alexandra Barratt, Kirsten Howard, Les Irwig, Glenn Salkeld, and Nehmat Houssami
BMJ 2005 330: 936. [Abstract] [Full Text] [PDF]

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