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Tuesday, 26 September, 2000, 18:32 GMT 19:32 UK
Screening 'could save thousands in Europe'
breast screening
Many countries do not have breast screening programmes
Thousands of lives might be saved if UK-style screening programmes were introduced throughout Europe, an doctor says.

Many countries, without a centralised health service like the NHS, find it hard to operate the sophisticated recall systems needed to track women and invite them for mammograms.

However, Dr Robin Wilson, clinical director of cancer services at Nottingham City Hospital, says that as well as saving lives by detecting cancers earlier, breast cancer screening has had a knock-on effect which has revolutionised the way the illness is approached in this country.

This, he says, has undoubtedly helped save many more lives.

His speech, to the European Breast Cancer Conference in Brussels, came on the day that a leading cancer expert claimed that the NHS programme was "deceiving" women, and that many were having unneccessary surgery.

Professor Michael Baum's remarks have been condemned by the NHS Screening Programme.

Dr Wilson said that before the development of screening, breast cancer care, and cancer care in general, had been delivered by a "disparate group" of physicians and surgeons, often with no great experience in the disease.

"Because of the screening programme," he said, "Specialist teams began to work together.

"It would have happened without the programme, but not as quickly."

Missing benefits

Other countries without screening programmes are missing out on all these benefits, he said.

At present, Sweden, Norway, Finland and Holland have national screening programmes. In Italy and France some areas are covered, while pilot programmes are just being introduced in Germany.

Professor Baum's attack comes a fortnight after evidence published in the British Medical Journal suggested that breast screening in the UK was saving hundreds of lives every year.

As an example, he spoke about a type of breast cancer called ductal carcinoma in situ, which affects the milk ducts of the breast.

One in four breast cancers is this type, although it does not always spread and become aggressive.

Prof Baum claimed that uncertainty among surgeons meant that many felt it necessary to perform a mastectomy nevertheless.

'False promises'

He said: "It is one of the false promises of the NHS.breast screening programme - come for screening, catch it early, andwe will save your breast. It is not true.

"I really think there is a deception going on.

"Three out of four women in whom DCIS is detected will suffer the cancer label, liable to have over-treatment, and may have problems with life insurance and health insurance."

However, a spokesman for the breast screening programme programme issued a strong rebuttal.

He said: "This is not the first time that Professor Baum has attacked the programme and he seems to have a scalpel to grind on this issue.

"He would do well to check the relevance of the facts he quoted, which are 25 years out of date.

"Of the 8,000 cancers detected by the programme, only 20% fall into the DCIS category and not all will necessarily lead to mastectomy. Most women will be offered a choice between mastectomy and less drastic treatment."

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