Last year, the UK Government announced a review of the evidence for breast screening as a result of on-going criticism from some quarters that the screening programme over states the benefits and downplays the harms associated to screening.
The review reported in October http://www.informedchoiceaboutcancerscreening.org/breast-cancer-screening-review-calls-for-clear-and-accessible-information-on-harms-and-benefits/ and showed that breast screening can save lives-around 1300 a year in the UK, that’s around 130 here in Scotland. But there are some downsides to screening reported in the review. The data suggests that 1 in 5 of those diagnosed through screening is over diagnosed. So some women are diagnosed and treated for a cancer that is at such an early stage it may not have caused them harm in their lifetimes. The problem is we don’t know at the moment which of those 1 in 5 cancers will grow and become harmful so all women in this situation will be offered treatment. To put these numbers in context, this translates to 1% of all the women screened at risk of overtreatment.
But let’s not forget that also means 4 in 5 women who have a cancer diagnosed through screening are having treatment for a cancer that will cause them harm if left untreated, and may not have been found without screening.
But I guess a big question is how do women make sense of this report? What do women do when the screening appointment drops through the door? It’s vital to read the information to decide to attend screening – or not, armed with the facts and confidence about possible actions to take. More information is also available through websites such as the Department of Health and breast cancer charities but these sites will be updated as the recommendations around information are developed over the next few months.
Breakthrough Breast Cancer will continue to work with governments in England and Scotland to get the leaflet as clear as possible and also provide and update information to enable informed choice at all times.
So, where now? Undoubtedly there is a need to push for more research to improve the evidence and increase the direction of targeted screening and treatment. However, it is essential to communicate authentically and clearly with women to aid their decisions to attend screening and any subsequent need for treatment. Finally and crucially women need support to help make a decision that’s right for them.
Breakthrough, along with other charities Breast Cancer Care and Breast Cancer Campaign, have looked at the outcome of this review and feel that yes, this is good news for women.
Audrey Birt, Scotland Director, Breakthrough Breast Cancer
This article was originally published in the SCPN Newsletter, Volume 4, Issue 1.
Read the full issue here: