Benefits of cancer screening take years to appreciate

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f299 (Published 16 January 2013) Cite this as: BMJ 2013;346:f299

Re: Benefits of cancer screening take years to appreciate

As someone who regularly talks to patients about breast cancer screening I can assure Professor Patnick that at invitation for mammography many of the risks are not immediately evident to the person concerned. The risks associated with overdiagnosis are glossed over in the NHS breast cancer screening leaflet with the single phrase "Screening may find cancers which are treated but which may not otherwise have been found in your lifetime". Many patients are surprised and bewildered to discover that most breast cancers detected by screening would not have caused them problems if left untreated, there is no evidence that screening reduces overall mortality, and the evidence that screening reduces breast cancer deaths at all is controversial.

Despite many calls for the patient literature to take a more balanced approach, the breast screening establishment still seems determined to pressurise women to accept screening mammography rather than giving them the opportunity to decide for themselves if they feel that the benefits outweigh the risks. This may be good for those whose salaries are paid by the breast cancer screening industry, but I'm not convinced that it is right for my patients.

Competing interests: No competing interests

20 January 2013
Jonathan D Sleath
General Practitioner
Kingstone Surgery
Kingstone, Hereford, HR2 9HN