Intended for healthcare professionals


How much is too much breast screening?

BMJ 2015; 350 doi: (Published 14 January 2015) Cite this as: BMJ 2015;350:h139
  1. Ingrid Torjesen, freelance journalist, London
  1. ingrid_torjesen{at}

Ingrid Torjesen describes how the government is pushing on with a giant trial of extended breast screening, despite serious concerns that women are not being fully informed of the risks

Since 2009 women in their late 40s and early 70s across England have been receiving letters inviting them to come for NHS breast screening and giving them an appointment time. The letter explains that screening for breast cancer is usually for women aged 50-70 years but that some women aged 47 to 49 and over 70 up to 73 are now also being invited, as part of a study.

Along with the letter comes the standard pink leaflet on breast screening produced for women aged 50-70, who have been offered regular breast scans under the national screening programme since 2004. Also included is a question and answer sheet explaining that the recipient lives in an area where the age range for breast screening is being widened. Randomly phasing in the extension by area will allow the net benefit of extending the age range to be “scientifically evaluated” by researchers at Oxford University, it explains. The letter does not explicitly ask for consent from the invited women to be entered into the study; instead consent is assumed when women turn up at the given appointment time.

Debate over harms versus benefits

The government decided to extend the age range for screening in 2007.1 The phased extension will offer mammography to 1.5 million women in the new age groups, whose breast cancer incidence and mortality will then be compared with another 1.5 million women not offered the screening.2 3

What the letter doesn’t explain, however, is that debate has been growing in recent years about whether the benefits of screening outweigh the harms, particularly to women under 50.

The government did not provide evidence in …

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