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Breast screening expectations 'too high'

Researchers at the department of public health and community medicine at the University of Sydney asked them how accurate they thought breast screening was and whether they would feel entitled to compensation if a routine screen failed to detect a cancer.

They found that 40% of the women said all cancers should be detected, and just under half said they should get financial compensation if one was missed.

Accuracy fears

However, the researchers point out that studies show screening to be only 75% to 95% accurate depending on the age of the woman screened.

They call for better education so women can have more realistic expectations of screening programmes, although they admit this may not curb the number of court cases brought against hospitals for missing cancers.

Writing in the British Medical Journal publication, the Journal of Epidemiology and Community Health, the researchers said that previous studies suggested that unrealistically high expectations contributed to a "sense of anger and betrayal if a cancer is missed".

"This may make women more likely to sue for negligence and financial compensation," they said.

Although they were unaware of hospitals being sued for missed cancers in a screening programme, they speculated that some cases could have been settled out of court.

"It has been argued that successful claims against a screening programme could render the breast and cervical screening programmes in Australia unsustainable because of increasing costs and increasing overdetection and overtreatment of minor abnormalities," they said.

Appeal cases

This is the line being taken by the East Kent Health Authority in an Appeal Court hearing over mistakes in the handling of cervical smears at the Kent and Canterbury Hospital.

Three women who developed cancer after getting the all-clear from cervical screeners won a medical negligence claim against the authority in February.

But the authority has argued that the original ruling may destroy the national screening programme because it sets standards of accuracy that are near impossible to achieve.

However, the authority has already paid out more than £1m to 47 women affected by the mistakes - the three women are among 14 cases it has disputed.

Developments

Commenting on the new study, Julietta Patnick, national co-ordinator of the NHS Screening Programme, said she accepted the levels of accuracy given and said studies were under way to establish what levels of accuracy were expected.

"Preliminary investigations indicate that the majority of women are unaware that screening can miss cancers," she said.

However, the programme was taking steps to improve accuracy, even though there was always the chance that cancers could develop between screenings, she said.

Relevant Stories

Health insight: Breast screening (20 Oct 99 | Health)
'No negligence' in missed cancers (04 Oct 99 | Health)
Smears ruling 'could destroy screening programme' (25 Mar 99 | Health)
Breast cancer factfile (23 Sep 98 | Medical notes)

Internet Links

NHS Breast Screening Programme
UK Breast Cancer Awareness Campaign
British Medical Journal

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