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Cancer Prevention in Primary Care: Screening and self examination for breast cancer

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6948.168 (Published 16 July 1994) Cite this as: BMJ 1994;309:168
  1. J Austoker
  1. Cancer Research Campaign Primary Care Education Research Group, Department of Public Health and Primary Care, University of Oxford, Oxford OX2 6PE.

    Breast cancer is the major form of cancer in women, with nearly 30 000 new cases and over 15 000 deaths in the United Kingdom each year. Breast screening by mammography has been shown in randomised trials to reduce mortality from breast cancer in women aged 50 and over. An NHS breast screening programme has been in operation in the United Kingdom since 1988. Its aim is to reduce mortality from breast cancer by 25% in the population of women invited to be screened. The uptake of mammography among the eligible population may be the single most important determinant if the programme is to be effective. Primary care teams have an important part to play in encouraging women to attend for screening and in providing information, advice, and reassurance at all stages of the screening process. To date, routine breast self examination has not been shown to be an effective method of screening for breast cancer and should not therefore be promoted as a primary screening procedure. There is, however, a case to be made for women to become more “breast aware.”

    Breast cancer: current facts

    Breast cancer is the major form of cancer among women in the United Kingdom. Nearly 30 000 new cases were diagnosed in 1988. Overall, it is estimated that 1 in 12 women will develop breast cancer at some time in their life.

    Breast cancer accounted for over 15 000 deaths in 1992, 19% of all deaths from cancer among women, and 5% of all deaths among women. The United Kingdom has the highest mortality rate from breast cancer in the world. Figure 1 shows the ages at which deaths from breast cancer occur. Mortality in women aged 15-44 has fallen slightly, but it has increased in all other age groups. Breast cancer is the commonest single cause of …

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