Views & Reviews Review

How we got it wrong with breast screening

BMJ 2012; 344 doi: (Published 17 May 2012) Cite this as: BMJ 2012;344:e3450
  1. Klim McPherson, visiting professor of public health epidemiology, University of Oxford
  1. klim.mcpherson{at}

Has mammography policy kept pace with science? Klim McPherson applauds a book that exposes the gaps between practice and the evidence

Peter Gøtzsche, having studied the science of mammography screening for a long time, is an angry man. And he has every reason to be. Like most public policy, that for mammography screening has apparently ignored much of the science. Unlike most public policy, however, breast screening is essentially a scientific medical service. In his book Mammography Screening: Truth, Lies and Controversies, Gøtzsche tells a fascinating story about how and why a costly, even iconic, public service for women has collectively behaved like a hunted tiger. There has not been enough calm and measured discussion of the evidence. This is a seminal account of the role of science in delivering a popular public screening service, which has enormous face validity and professional commitment. At issue is the emerging evidence from continuous follow-up of a service that began in the …

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