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Over-diagnosis in breast cancer screening

BMJ 2006; 332 doi: (Published 23 March 2006) Cite this as: BMJ 2006;332:691
  1. Henrik Møller, professor (,
  2. Elizabeth Davies, senior lecturer1
  1. 1 King's College London, Thames Cancer Registry, London SE1 3QD
  1. Correspondence to: H Møller

    The article by Zackrisson et al is an important follow-up study of diagnosis of breast cancer in women in the Malmö mammographic screening trial.1

    In 2002 the International Agency for Research on Cancer concluded that population mammographic screening for women aged 50-69 years reduces the mortality from breast cancer by about one third.2 But screening can also lead to over-diagnosis and over-treatment.3

    Over-diagnosis arises from two distinct phenomena: anticipation of diagnoses and excess diagnoses. Anticipation is the earlier diagnosis of cancers that would otherwise have become symptomatic and presented later: this phenomenon is both expected and desirable.

    Excess diagnosis relates to cases detected through screening that would otherwise never have presented. A few may be false positive histological …

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