Breast cancer mortality in neighbouring European countries with different levels of screening but similar access to treatment: trend analysis of WHO mortality database

I have just come off the air following a phone in programme with BBC
Belfast with one of the authors of this paper, Anna Gavin, in the studio.

She and I agreed on the importance of their findings and if nothing else
the urgent need to convene an international panel of experts to review the
status of screening for breast cancer in the light of the surfeit of new
data that are emerging to challenge the status quo. We begged to differ on
what we might do in the short term, she favoured carrying on regardless I
favoured improving the consent procedures and considering a policy of risk
assessment/risk management. All the women who phoned in were anxious to
describe how screening saved their lives, which of course rather spiked my
guns, as I wouldn't want to disillusion them on air.

What was unforgiveable however was the pronouncement from the Northern
Ireland Public Health Agency (NIPHA), which was read out on air,
describing 5year survival data from screen and clinical detected breast
cancer; as the figure for the screen detected disease was so much better
than for the clinically detected disease, they urged women to ignore these
new observations and keep their appointments at the screening clinics..

Anyone who knows the first thing about screening should be aware, that as
an outcome measure, 5 year survival is meaningless because of the lead
time bias and the bias of over-detection. If the NIPHA is unaware of this
they should not be in charge of public health and if they are aware of
this then they are guilty of a gross deception engineered to further
control the behaviour of the innocent women in the province.