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Cancer screening—how can we do better?

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7150.88a (Published 04 July 1998) Cite this as: BMJ 1998;317:88
  1. Rebecca Roylance, clinical research fellow
  1. London, and Jonathan Waxmanconsultant physician, London

    Cancer is the second most common cause of death in the United Kingdom. Our attempts to reduce cancer deaths are mainly directed towards improving treatments, with comparatively little spent on prevention.

    In an attempt to rectify this, expensively advertised government sponsored screening campaigns have been launched in the past decade, sometimes coinciding with election campaigns and often without the support of a medical consensus. Recent high profile mistakes have highlighted the inadequacies of the current service, where human error has led to false negative and positive reporting of breast and cervical cancer. These errors have occurred throughout Britain, most recently for cervical cancer in Kent and for breast cancer in Devon.

    These errors have arisen because screening is currently a subjective rather than an objective process depending on an individual's interpretation of microcalcification or architectural distortion on a mammogram or the appearances of nucleus and cytoplasm on a smear. In order to limit these errors computerised screening processes need to be introduced that provide an objective analysis of the risk …

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