Study confirms breast screening saves lives

The BBC reports how a new study, led by the World Health Organization's cancer agency, proves the effectiveness of breast cancer screening worldwide. 29 independent experts from 16 countries looked at 40 different studies and concluded that screening really did save lives.

The NHS estimates it saves 1,300 lives a year from breast cancer in the UK – but the proportion of women attending screening in England has dipped over the past few years, suggesting faltering confidence in its effectiveness.

 2012 saw heated debate about the potentially negative effects of screening – including increased risk from exposure to radiation during mammograms, and over-diagnosis, which can sometimes lead to unnecessary treatment. The findings of a UK review prompted the government to issue new information on the risks – but this latest report, published in the New England Journal of Medicine, gives clear support to current NHS advice, which recommends women aged 50-69 are screened every three years.

Gordon Wishart, Professor of Cancer Surgery and Medical Director of Check4Cancer, comments: “I hope this helps to reassure women that screening is worthwhile. As with all forms of cancer, early detection is key to effective treatment – and breast cancer is actually one of the best examples we have of the impact of early detection on survival.”

Like other types of cancer, the incidence of breast cancer is increasing, with over 50,000 new cases in the UK per annum. However, the mortality rate for breast cancer has actually been falling since the 1980s. There is no doubt that screening has played a role in this reduction in mortality.

“To put this into perspective,” adds Professor Wishart, “it’s helpful to compare breast cancer with lung cancer. This is the second most common cancer in the UK after breast cancer, but the biggest killer. There is no screening programme at all for lung cancer, and 90% of cases come to light as a result of symptoms such as weight loss, or coughing up blood. By the time this happens, however, it is already too late for effective treatment.

“43,463 new cases of lung cancer were diagnosed in UK in 2011 – a slightly lower incidence than breast cancer – but by comparison the number of deaths is huge. There were 11,716 deaths from breast cancer in the UK in 2012, but 35,400 from lung cancer. If lung cancer were screened as effectively as breast cancer is, we could expect to see the number of deaths reduced by as much as two thirds.

“Breast cancer screening is a success story – but this success can only continue if women have faith in it. This is not just about reassurance; there are legitimate concerns. Mammograms do carry a small risk of radiation exposure, and so should not be carried out if they are not necessary. This is precisely why Check4Cancer – who offer testing to women in a younger age range, potentially accessed as a benefit through their employers – start the process with a questionnaire about lifestyle and family history, then a thorough examination with an experienced nurse. Only then are women who are considered at higher risk referred for mammography. This approach keeps overdiagnosis to a minimum.

“The better we in the UK target our screening services, the higher the success rate will be – and the more confidence women will have in it.”