Intended for healthcare professionals


Breast cancer screening

BMJ 2017; 359 doi: (Published 06 December 2017) Cite this as: BMJ 2017;359:j5625

Re: Breast cancer screening

It is now time to take heed to calls for there to be a controlled deimplementation of screening by mammography. [1] [2] [3] Mounting evidence about harms and overdiagnosis, together with an increasing and pressing need to use both our financial and health professional resources wisely, without wastage, indicate a strong imperative for those responsible to take action without any further prevarication. Citizens are not being served justly or well by profligate spending on interventions that are demonstrably damaging both citizens and the public purse. Harms to citizens, both accepters and decliners, and those treated and untreated, are numerous, and have been well-documented.

How much longer do we have to go on waiting for those responsible to acknowledge that breast screening by mammography as now offered is not fit for purpose, is wasting valuable resources and harming more citizens than it helps? It is time, as suggested [1], for them to acknowledge that “the logical consequence of recent evidence is to start a discussion about controlled deimplementation of invited screening with mammography.”

[1] Mette Kalager `Breast cancer screening` BMJ 2017;359:j5625

[2] Autier P, Boniol M, Koechlin A, Pizot C, Boniol M. Effectiveness of and overdiagnosis from mammography screening in the Netherlands: population based study. BMJ 2017;359:j5224.

[3] Doublvetsky J V, Robert V, Nicot P, Bour C. Collectif Cancer Rose. Rapid response to [2] above.

Competing interests: No competing interests

08 December 2017
Hazel Thornton
Honorary Visiting Fellow, Department of Health Sciences
University of Leicester
"Saionara", 31 Regent Street, Rowhedge, Colchester, CO5 7EA