Breast screening: the facts--or maybe not

doi:10.1136/bmj.b86

Published 27 January 2009, doi:10.1136/bmj.b86
Cite this as: BMJ 2009;338:b86

Analysis

Breast screening: the facts—or maybe not

Peter C Gøtzsche, director¹, Ole J Hartling, consultant², Margrethe Nielsen, PhD student¹, John Brodersen, lecturer³, Karsten Juhl Jørgensen, researcher¹

¹ Nordic Cochrane Centre, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark, ² Department of Nuclear Medicine, Vejle Sygehus, Denmark, ³ Department of General Practice, University of Copenhagen, Denmark

Correspondence to: P C Gøtzsche pcg@cochrane.dk

Peter Gøtzsche and colleagues argue that women are stillnot given enough, nor correct, information about the harms ofscreening

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

Three years ago, we published a survey of the information givento women invited for breast screening with mammography in sixcountries with publicly funded screening programmes.¹ The majorharm of screening, which is overdiagnosis and subsequent overtreatmentof healthy women, was not mentioned in any of 31 invitations.¹Ten invitations argued that screening either leads to less invasivesurgery or simpler treatment, although it actually results in30% more surgery, 20% more mastectomies, and more use of radiotherapy²because of overdiagnosis.³ ⁴ Pain caused by the procedure wasmentioned in 15 invitations, although it is probably the leastserious harm, as it is transient.

Since then, little has changed. Our 2006 article included abox with recommended information and numbers needed to benefitand to harm.¹ Although the information leaflet used in the UnitedKingdom has since been updated,⁵ the contents remain essentiallythe same. The leaflet has the authoritative . . . [Full text of this article]

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati What's this?

Relevant Articles

Breast screening saves lives: Nicholas J Wald, Malcolm R Law, and Stephen W Duffy
BMJ 2009 339: b2922. [Extract] [Full Text]

Overdiagnosis and mammography screening: H Gilbert Welch
BMJ 2009 339: b1425. [Extract] [Full Text]

Less medicine is more: Fiona Godlee
BMJ 2009 338: b2561. [Extract] [Full Text]

Will ductal carcinoma in situ defeat breast cancer screening?: John R Benson
BMJ 2009 338: b957. [Extract] [Full Text]

Reality of ductal carcinoma in situ: Jane Flanders
BMJ 2009 338: b958. [Extract] [Full Text]

Standardise all leaflets now: Ruth Talbot, James Williamson, and Alexandra Martin
BMJ 2009 338: b975. [Extract] [Full Text]

Tricky thing, choice: Jane Smith
BMJ 2009 338: b707. [Extract] [Full Text]

Content of invitations for publicly funded screening mammography: Karsten Juhl Jørgensen and Peter C Gøtzsche
BMJ 2006 332: 538-541. [Full Text] [PDF]

Incidence of breast cancer in Norway and Sweden during introduction of nationwide screening: prospective cohort study: Per-Henrik Zahl, Bjørn Heine Strand, and Jan Mæhlen
BMJ 2004 328: 921-924. [Abstract] [Full Text] [PDF]

Women need better information about routine mammography: Hazel Thornton, Adrian Edwards, and Michael Baum
BMJ 2003 327: 101-103. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

Wald, N. J, Law, M. R, Duffy, S. W (2009). Breast screening saves lives. BMJ 339: b2922-b2922 [Full text]
Welch, H G. (2009). Overdiagnosis and mammography screening. BMJ 339: b1425-b1425 [Full text]
Roberts, A. W., Clark, A. L., Witte, K. K. (2009). Review article: Left ventricular dysfunction and heart failure in metabolic syndrome and diabetes without overt coronary artery disease -- do we need to screen our patients?. Diabetes and Vascular Disease Research 6: 153-163 [Abstract]
Benson, J. R (2009). Will ductal carcinoma in situ defeat breast cancer screening?. BMJ 338: b957-b957 [Full text]
Flanders, J. (2009). Reality of ductal carcinoma in situ. BMJ 338: b958-b958 [Full text]
Talbot, R., Williamson, J., Martin, A. (2009). Standardise all leaflets now. BMJ 338: b975-b975 [Full text]

Rapid Responses:

Read all Rapid Responses

Screen credits: John Doherty
bmj.com, 29 Jan 2009 [Full text]
Shared decision-making: mammography screening: David L. Hahn
bmj.com, 29 Jan 2009 [Full text]
Re: Shared decision-making: mammography screening: Nazar R Dessouki, et al.
bmj.com, 30 Jan 2009 [Full text]
Inadequacy of information after screening: Paul D Pharoah
bmj.com, 3 Feb 2009 [Full text]
Breast Screening - the real facts every woman needs to know: Mitzi A J Blennerhassett
bmj.com, 3 Feb 2009 [Full text]
Re: Breast Screening - the real facts every woman needs to know: Nina (M) Sawicki
bmj.com, 4 Feb 2009 [Full text]
More "pre-disease": John Nottingham
bmj.com, 4 Feb 2009 [Full text]
Inappropriate Picture: Kevin F Donnelly
bmj.com, 20 Feb 2009 [Full text]
Unhealthy paternalism: Mitzi A J Blennerhassett
bmj.com, 20 Feb 2009 [Full text]
Enabling informed choice for healthy women invited to mammographic screening: Hazel Thornton
bmj.com, 21 Feb 2009 [Full text]
Is there an age when breast screeening should not be recommended?: Joseph More
bmj.com, 21 Feb 2009 [Full text]
DCIS: the reality from a patient's perspective: Jane Flanders
bmj.com, 21 Feb 2009 [Full text]
Personal Experience of Screening: Margi Levy
bmj.com, 22 Feb 2009 [Full text]
Impact of your article: Ylva KM French
bmj.com, 23 Feb 2009 [Full text]
Will DCIS inevitably defeat breast cancer screening?: John R Benson
bmj.com, 24 Feb 2009 [Full text]
Research findings: "everyone`s business!": Hazel Thornton
bmj.com, 24 Feb 2009 [Full text]
"The Facts - or maybe not": Ruth E. Talbot, et al.
bmj.com, 27 Feb 2009 [Full text]
Response to Gotzsche: Nicholas J Wald, et al.
bmj.com, 27 Feb 2009 [Full text]
Breast cancer - properties of screening and understanding the progression of in-situ and indeterminate lesions.: Masoom Muttalib
bmj.com, 2 Mar 2009 [Full text]
Metabolic screening for breast cancer?: Richard G Fiddian-Green
bmj.com, 3 Mar 2009 [Full text]
Estimate of breast screening benefit was 6 times too large: Peter C G�tzsche, et al.
bmj.com, 3 Mar 2009 [Full text]
Metabolic screening using thermography and magnetic resonance pH imaging.: Richard G Fiddian-Green
bmj.com, 5 Mar 2009 [Full text]
Re: Estimate of breast screening benefit was 6 times too large: Stephen W. Duffy
bmj.com, 29 Mar 2009 [Full text]
Who isn't 'doing the math' right here?: Jane Flanders
bmj.com, 23 Apr 2009 [Full text]
Stephen Duffy's claims on the benefits and harms of breast screening are seriously wrong: Peter C G�tzsche, et al.
bmj.com, 1 May 2009 [Full text]
Preventive Medicine: Daphne Havercroft
bmj.com, 2 May 2009 [Full text]
Limitations of Mammography for diagnosis of breast cancer: Mounir Nassar
bmj.com, 4 Jul 2009 [Full text]