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The BBC's Fergus Walsh
"Common sense suggests breast screening must save lives"
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The BBC's Richard Hannaford
"They conclude that screening for breast cancer is not worthwhile"
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Dr Muir Gray, Breast Cancer Screening Campaign
"This is very important information"
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Friday, 7 January, 2000, 17:03 GMT
Pledge to extend breast screening

Research casts doubt on the value of breast screening

Breast screening is likely to be offered to older women in future, despite claims by experts that it does not save lives.

Women will be screened until the age of 69, ministers have pledged, provided pilot studies currently underway prove successful.

A storm has erupted over research published in a medical journal, which claims that screening for breast cancer does not benefit women.

Health minister Yvette Cooper said: "The interim results from the three pilot sites have been positive. We will be extending the breast screening programme to women aged 65 to 69 if the studies show it would be beneficial."

The final results from the pilot studies are expected in the spring.

Friday's study, published in the Lancet, states that many previous studies which had shown the benefits of screening were flawed, and even suggests that it may do more harm than good.

This report is not a positive contribution to the debate
Delyth Morgan, Breakthrough Breast Cancer
However, it has been roundly attacked by many leading cancer charities, who have criticised the scientific methods of its authors, who are based in Copenhagen, Denmark.

These, along with government bodies responsible for health screening, say the publicity could deter women from having mammography tests - and miss out on the early detection of tumours.

Professor Muir Gray, chairman of the National Screening Committee, said: "I would call this a half-baked report - there is no new information here."

Professor Gordon McVie, director general of the Cancer Research Campaign said: "Deaths from breast cancer have fallen significantly in the last 10 years.

"There's no doubt that more early cancers are being detected due to the screening programme. This means that not only do women survive longer, but they are spared disfiguring surgery and aggressive treatments."

Breast screening facts and figures
Female mortality from breast cancer dropped 14% between 1989 and 1998
In 1999 the programme reported detection of 3,381 cancers smaller than 15mm - up 7%
In 1997/98 the programme detected 7,932 cancers - up 11%
68% of women diagnosed with breast cancer in 1986-1990 were alive five years later
The NHS breast screening programme in England costs 37m annually - approximately 25 for each woman between the ages of 50 and 64 invited for an examination.

The Danish researchers were prompted to look again at eight large-scale studies of breast screening by the fact that breast cancer mortality has not improved significantly in Sweden despite having an established screening programme.

They found what they described as "inconsistencies" in six of the eight studies which they said made them less reliable.

This ruled out all the studies - including one carried out in Scotland - which appeared to show the benefits of screening, and left only two, in Sweden and Canada, which showed no apparent benefits.

"We conclude that screening for breast cancer with mammography is unjustified," the team wrote.

'Screening moved on'

However, Dr Alistair Thompson, breast cancer specialist based at Ninewells Hospital in Dundee, says the study was based on old statistics and much had moved on since.

"In Scotland now screening is very very efficient. We are able to pick up small breast cancers and cure them. There is clear evidence that screening does save lives.

"It is always worth looking back and re-addressing the question of what has gone on in the past.

"But the situation is vastly different today - the quality of the imaging has improved, the quality of the people conducting the screening is now very high.

"I would encourage women to go for screening because it could very well save their lives."

And Delyth Morgan, the chief executive of Breakthrough Breast Cancer, said the report was not a "positive contribution to the debate" into the effectiveness of breast screening programmes.

"We must not be deterred from continuing our screening programme until we have seen categorically that they are ineffective. Our expectation in the UK is that this is not the case."

Even an accompanying article in the Lancet was critical of the research, claiming it had ignored a number of important factors.

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See also:
11 Mar 99 |  Health
Breast screening row hots up
04 Jan 00 |  Health
Cancer rates rising
04 Jan 00 |  Health
The future of cancer treatment
08 Dec 99 |  Health
Prince backs breast cancer blitz
15 Feb 99 |  Health
Breast cancer fears torment women
20 Oct 99 |  Health
Breast screening expectations 'too high'

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