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Critics attack new NHS breast screening leaflet for failing to address harms

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c7267 (Published 16 December 2010) Cite this as: BMJ 2010;341:c7267
  1. Susan Mayor
  1. 1London

A new NHS leaflet on breast cancer screening is “a disgrace, and should be scrapped,” an international screening researcher has said. He is concerned that the information is unbalanced in favour of screening and that the major harms of screening—overdiagnosis and treatment—are not clearly explained.

Peter Gøtzsche, director of the Nordic Cochrane Centre, Righospitalet, Copenhagen, Denmark, said, “The leaflet is very unbalanced. It includes figures that overestimate the number of breast cancer deaths saved by screening and fails to give sufficient information on the harms to enable women invited for screening to give fully informed consent.”

Michael Baum, professor emeritus of surgery and director of clinical trials at University College London, UK, agreed. “The whole thing is self serving,” he said. “It aims to encourage women into screening by manipulating the data,” he alleged. “The agents of the state are behaving in an almost Stalinist fashion to coerce women into an activity that has marginal benefit.”

Hazel Thornton, visiting fellow in health sciences at the University of Leicester also thinks that the leaflet, which was published on 13 December, lacks balance. “It is not a balanced presentation of harms and benefits, and its layout, framing and language still emphasise benefits at the expenses of harms. It is not ‘neutral,’” she said.

In a statement, Juliette Patnick, director of the NHS Cancer Screening Programmes said, “The leaflet was produced independently from the NHS by a team led by Joan Austoker, a leading expert on informed choice [who has since died]. Her team used robust research and testing techniques. Published research on breast screening was reviewed …

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