One third of women avoid routine mammogram tests

Published on September 30, 2009 at 12:03 AM

On the eve of Breast Cancer Awareness Month, Cancer Research UK today sends out a warning that if thousands of women continue to ignore invitations to breast screening they could be putting their lives at risk.

The NHS breast screening figures have shown that around three in 10 women still do not attend screening*.

In 2008, out of 2.2 million women who were sent an invitation for screening, 1.7 million attended - around 73 per cent.

Now experts are predicting that if all women attended screening when invited, then around 600 extra lives could be saved each year.

In January the number of women in England newly invited for screening fell below 70 per cent for the first time.

Former airline stewardess Barbara Gibbs, from Berkshire, believes a routine mammogram saved her life. Twelve years ago she was diagnosed with breast cancer after she was called back for a second mammogram after she had gone for breast screening.

"After surgery I was given six weeks of radiotherapy and then put on tamoxifen for five years," says Barbara who is now 68. "I was lucky because my cancer was caught early even though I had no lump and no symptoms.

"I wouldn't be alive today if I hadn't gone for that mammogram. I feel very positive that I am a survivor and I just can't emphasise how strongly I feel that women must take up their invitation to breast screening. It certainly saved my life because the cancer was caught early and treated promptly."

Doreen Walker, from Potters Bar, who now volunteers in one of Cancer Research UK's charity shops, was also diagnosed with breast cancer following a routine mammogram 16 years ago, a year after retiring from the NHS.

"I feel very lucky to have been picked up by screening. I made sure I went for a mammogram every three years and honestly believe I wouldn't be here today if it wasn't for breast screening. I would certainly recommend that all women go for their appointments - it is vital for every woman and could save their life," says Doreen who is now 78.

With more than 45,500 women diagnosed with breast cancer in 2006 it is now the most common cancer in the UK.

In England the NHS breast screening programme diagnoses around 10,000 cases of breast cancer each year and saves around 1,400 lives every year.

Dr Lesley Walker, Cancer Research UK's director of cancer information, said: "Screening saves lives, so it's extremely worrying to see that the percentage of women going for screening is dropping. Mammograms pick up the very early signs of breast cancer when it's much easier to treat. Even though the screening programme saves around 1,400 lives each year we predict that if there was 100 per cent attendance, hundreds more lives could be saved.

Really excellent article in the BMJ (British Medical Journal) over the summer on the overdiagnosis that is an inevitable feature of screening mammography.

Please see www.bmj.com/.../b2587

The point of this research published in the British Medical Journal is that mammography finds harmless lesions that look like cancer (even under a microscope), but are meaningless.  This leads women to get cancer treatment that they don’t need.  Women routinely get all or part of a breast removed, get radiation that can cause lung cancer and deadly heart problems, and receive toxic chemotherapy ALL FOR NOTHING.  This happens in 1 of 3 cases of “breast cancer” that are identified via mammography screening.  These women are all told how lucky they are, when in reality if they hadn’t been screened they would have never had breast cancer at all.  Hard to believe, but it’s true.

It is clear at this point that most older women have cancer cells in their breasts, but the majority of the time these will not grow or spread, and they may disappear on their own.  Yet if this harmless condition is found, the woman will be put through the cancer mill, all the while being told how “lucky” she is.

In the United States, there is a huge propaganda machine that bullies and pushes women into mammography without informing them of the risks.  Instead women are told that if they get screened maybe they won’t need a mastectomy, but just a little tiny operation.  However, women who are screened via mammography are about 30% more likely to have the entire breast cut off than women who refuse screening.  Yet we never hear about this.  For shame!

Problems with cancer screening are well-known.  For instance, a man is 48 times more likely to be harmed by prostate cancer screening (the PSA test) than to benefit from it.  He could end up getting surgery that leaves him incontinent and impotent.  The radiation treatments he endures could cause bowel problems.  He may have to use adult diapers for the rest of his life, and there’s a good chance that he won’t able to have sex even with Viagra.  All for nothing.  The American Cancer Society has recently stopped pushing the PSA test for this reason.  Hopefully, soon they will stop their shameful promotion of screening mammography as well.

Please see http://www.screening.dk/folder_uk.pdf for accurate information on mammography.

Below is some of eminent breast surgeon Dr. Michael Baum’s response to first article:

Since the publication of the paper on over-diagnosis of breast cancer at screening by Karsten Juhl Jorgensen and Peter C Gøtzsche in the BMJ this week, there has been a flurry of media activity with the high profile appearances of the usual apologists for the NHS breast-screening programme (NHSBSP). From this and previous excursions it is clear to me that the NHSBSP employs a PR machine against which individual clinical scientists such as myself have to compete. Surely as with the debate on chiropractics featured in the same issue, the correct response should be through scholarly disputation in the journals, rather than by sound bite.
To me the central issue in the debate is that the pro-screening lobby is locked into a mind set dating back to the late 1980s. Since then our understanding of the biology of breast cancer and its treatment has moved on whilst the screening programme continues without modification based on the results of trials reported up to 1987 and started more than 10 years of that date. As a result of this I can describe at least three problems that have to be addressed.
With the maturation of these old trials and subsequent overview analyses the estimates of benefits in terms of relative risk reductions in cause specific mortality have fallen from 25%, upon which the NHSBSP was predicated, to about 15%. [1]
Next, as described in Jørgensen and Gøtzsche’s paper, estimates of harm through over-diagnosis have increased. At the same time our understanding of the biology of breast cancer has improved so that the idea of latent or self limiting pathology that is so counter-intuitive to the screening community, is no longer surprising to those who have bothered to keep up to date.

Continues…