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Breast cancer screening

BMJ 2000; 321 doi: (Published 02 September 2000) Cite this as: BMJ 2000;321:567

Screening has to be combined with good surgical and oncological services

  1. Carlo Palmieri (, Cancer Research Campaign clinical research fellow,
  2. Sam Fishpool, medical student
  1. Department of Cancer Medicine, Cancer Cell Biology Section, Cancer Research Campaign Laboratories, Imperial College School of Medicine—Hammersmith Campus, London W12 0NN
  2. Department of Child Health, University of Newcastle, Newcastle upon Tyne NE1 4LP

    EDITOR—Dickinson in her editorial stated that there are serious doubts about the contribution of breast screening to a fall in breast cancer deaths.1 This statement is based on the controversial article by Gotzsche and Olsen,2 which at the time of its publication attracted much media attention. The repetition of this allegation without a more balanced view is erroneous, seems to support the findings of this article unequivocally, and has the potential to undermine confidence in the breast screening programme.

    The article by Gotzsche and Olsen was based on a meta-analysis of eight randomised trials of breast screening including half a million women. Because of the randomisation process and using age as a marker of imbalance, Gotzsche and Olsen believed that only the trials from Malmö and Canada were methodically correct, and because these two trials failed to show a survival advantage in the screened group, they concluded that breast screening was …

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