Published 23 June 2009, doi:10.1136/bmj.b2529
Cite this as: BMJ 2009;338:b2529

Observations

Life and Death

It is not wrong to say no

Why are women told only the benefits of breast screening and none of the possible harms?

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

I have seen enough women die from breast cancer to know very clearly what a terrible disease it can be and to understand the motivation that drives attempts to promote early diagnosis and curative treatment. It is not possible to take this issue lightly, and yet I have cheerfully declined successive NHS invitations to attend for my own screening mammography. My worry is that I have made this decision on the basis of information that is not readily available to my patients.

In the United Kingdom each mammography invitation encloses the leaflet Breast Screening: The Facts, a title that in itself seems to deny any sense of the uncertainties permeating the programme. The unforgivable feature of this leaflet is that, despite protests and promises of improvement, it still emphasises only the benefits of screening and makes no mention of the possible harms. Yet every practising clinician knows that screening . . . [Full text of this article]

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