Intended for healthcare professionals

Letters Breast cancer awareness month

Still awaiting screening facts

BMJ 2010; 341 doi: (Published 02 November 2010) Cite this as: BMJ 2010;341:c6152
  1. Michael Baum, professor emeritus of surgery and visiting professor of medical humanities1,
  2. Hazel Thornton, independent lay advocate for quality in research and healthcare2,
  3. Peter C Gøtzsche, professor of clinical research design and analysis and director3
  4. on behalf of Susan Bewley, Karsten Juhl Jørgensen, Alexandra Barratt, Nick Ross, Steven Woloshin, Lisa Schwartz, Toni Musiello, Mitzi Blennerhassett, Maryann Napoli, Cornelia J Baines, Jayant S Vaidya, Norman Williams, Daphne Havercroft, Per-Henrik Zahl, Michael Retsky, Robert M Kaplan, Mary Dixon-Woods Donald A Berry, Keith Isaacson, Diana Brahams, Miriam Pryke, Gillian Tindall, David A Bender, Tom Marshall.
  1. 1University College London (UCL), London, UK
  2. 2Colchester CO5 7EA, UK
  3. 3Nordic Cochrane Centre, Copenhagen, Denmark
  1. michael{at}

On 19 February 2009 we wrote a letter in the Times calling for the leaflet, Breast Screening: the Facts, to be rewritten because none of the invitations for screening told the truth about its harms and benefits.1 Two days later the Times reported that the national cancer director, Professor Mike Richards, had stated that a formal review of the guidance on screening had already begun, and that a new leaflet would be issued in autumn 2009.2 The promised leaflet is still unavailable. Since then, three million more women have been deprived of the means of making a proper decision regarding screening.

The issue is now even graver, as shown by recent analysis of the impact of screening in Norway.3 The accompanying editorial summed up the negative findings of that paper as follows: “If you screen 2500 women over the age of 50 for 10 years, then one breast cancer death might be avoided at the cost of 1000 false alarms and between five and 15 women being over-diagnosed and treated needlessly with surgery, radiotherapy, and chemotherapy.”4

A recent independent review of the evidence of benefits and harms of screening for breast cancer came to similar conclusions and asked for breast cancer screening to be independently reviewed by the National Institute for Health and Clinical Excellence.5

How much longer do we have to wait for action?


Cite this as: BMJ 2010;341:c6152


  • Competing interests: None declared.


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