{"id":2127,"date":"2013-02-01T16:36:44","date_gmt":"2013-02-01T14:36:44","guid":{"rendered":"https:\/\/www.caperay.com\/blog\/?p=2127"},"modified":"2014-09-30T08:57:39","modified_gmt":"2014-09-30T06:57:39","slug":"breast-cancer-screening-causes-harm","status":"publish","type":"post","link":"https:\/\/www.caperay.com\/blog\/breast-cancer-screening-causes-harm\/","title":{"rendered":"Breast Cancer Screening Causes Harm"},"content":{"rendered":"\n<!-- Facebook Like Button v1.9.6 BEGIN [http:\/\/blog.bottomlessinc.com] -->\n<iframe src=\"http:\/\/www.facebook.com\/plugins\/like.php?href=https%3A%2F%2Fwww.caperay.com%2Fblog%2Fbreast-cancer-screening-causes-harm%2F&amp;layout=standard&amp;show_faces=false&amp;width=300&amp;action=like&amp;colorscheme=light&amp;font=arial\" scrolling=\"no\" frameborder=\"0\" allowTransparency=\"true\" style=\"border:none; overflow:hidden; width:300px; height: 30px; align: left; margin: 2px 0px 15px 0px\"><\/iframe>\n<!-- Facebook Like Button END -->\n<p><a href=\"https:\/\/www.caperay.com\/blog\/wp-content\/uploads\/2013\/02\/BMJ_Logo-1\" target=\"_blank\"><img decoding=\"async\" class=\"alignright size-medium wp-image-2134\" title=\"BMJ_Logo\" src=\"https:\/\/www.caperay.com\/blog\/wp-content\/uploads\/2013\/02\/BMJ_Logo-1-300x170.jpg\" alt=\"\" width=\"190\" srcset=\"https:\/\/www.caperay.com\/blog\/wp-content\/uploads\/2013\/02\/BMJ_Logo-1-300x170.jpg 300w, https:\/\/www.caperay.com\/blog\/wp-content\/uploads\/2013\/02\/BMJ_Logo-1-1024x581.jpg 1024w, https:\/\/www.caperay.com\/blog\/wp-content\/uploads\/2013\/02\/BMJ_Logo-1.jpg 1057w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a> Every year the National Health Service in the\u00a0United Kingdom\u00a0<a href=\"http:\/\/www.cancerscreening.nhs.uk\/breastscreen\/cost.html\" target=\"_blank\">spends \u00a396 million<\/a>\u00a0on its breast screening programme. Despite\u00a0<a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(12)61611-0\/abstract\" target=\"_blank\">a\u00a0commissioned report<\/a>\u00a0by an eminent physician, Sir Michael Marmot,\u00a0published in the\u00a0<i>Lancet<\/i>\u00a0in November 2012, recommending that screening be\u00a0continued, controversy persists. The Marmot report concluded that the programme\u00a0prevented 43 deaths from\u00a0breast cancer for every 10,000 women invited for\u00a0screening, but also estimated the rate of overdiagnosis at almost 20%. Of the\u00a0681 cancer lesions detected in those 10,000 women, 129 would not have\u00a0led to\u00a0symptoms or caused her death.<\/p>\n<p>The harm caused by overdiagnosis is not only\u00a0that it can lead to anxiety associated with the \u201ccancer\u201d label, it is the\u00a0subsequent overtreatment that concerns many doctors. The latest edition of the\u00a0<i>British\u00a0Medical Journal<\/i>\u00a0has\u00a0<a href=\"http:\/\/www.bmj.com\/content\/346\/bmj.f477\" target=\"_blank\">focused on this controversial topic<\/a>, with two\u00a0editorials, a personal view by a breast surgeon, and a research report about\u00a0women\u2019s views on overdiagnosis.<\/p>\n<p>Michael Baum, an emeritus professor of surgery\u00a0at University College London and an early supporter of the UK\u2019s breast\u00a0screening programme,\u00a0<a href=\"http:\/\/www.bmj.com\/content\/346\/bmj.f385\" target=\"_blank\">is an outspoken critic<\/a>\u00a0of the Marmot report, suggesting\u00a0that\u00a0it pays scant attention to overtreatment. He argues that treatment carries\u00a0significant risks, particularly radiotherapy which can compromise coronary\u00a0artery and lung function and lead to death. In fact, he\u00a0estimates that for\u00a0every life saved by screening, an additional one to three deaths could be expected\u00a0from other causes as a result of overtreatment.<\/p>\n<p><a href=\"https:\/\/www.caperay.com\/blog\/wp-content\/uploads\/2013\/02\/Shutterstock_Diagnosis-1\" target=\"_blank\"><img decoding=\"async\" class=\"size-medium wp-image-2135 alignleft\" title=\"Shutterstock_Diagnosis\" src=\"https:\/\/www.caperay.com\/blog\/wp-content\/uploads\/2013\/02\/Shutterstock_Diagnosis-1-300x236.jpg\" alt=\"\" width=\"320\" srcset=\"https:\/\/www.caperay.com\/blog\/wp-content\/uploads\/2013\/02\/Shutterstock_Diagnosis-1-300x236.jpg 300w, https:\/\/www.caperay.com\/blog\/wp-content\/uploads\/2013\/02\/Shutterstock_Diagnosis-1.jpg 1000w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\nWomen who are invited for screening are\u00a0informed of the benefits but often told very little about the harms such as\u00a0overdiagnosis.\u00a0<a href=\"http:\/\/www.bmj.com\/content\/346\/bmj.f158\" target=\"_blank\">Researchers in Australia have explored<\/a>\u00a0how awareness of\u00a0diagnosis\u00a0might influence attitudes and intentions among women who are eligible\u00a0for screening. The 50 subjects asked pertinent questions, such as: Why is it\u00a0not possible to distinguish non-threatening cancers\u00a0from the potentially\u00a0dangerous ones that require treatment? Interestingly, most women said they\u00a0would still attend screening if the overdiagnosis rates were 30% or lower, but\u00a0a rate of 50% or higher\u00a0would cause them to reconsider.<\/p>\n<p>So where does this leave us? Breast cancer is a\u00a0heterogeneous disease and by understanding the basic biology we should be able\u00a0to identify those cancer cells that are likely to remain asymptomatic\u00a0during\u00a0the patient\u2019s lifetime.\u00a0<a href=\"http:\/\/www.bmj.com\/content\/346\/bmj.f87\" target=\"_blank\">As Cliona Kirwan concludes<\/a>, \u201cPerhaps the greatest\u00a0priority for now is to minimise the impact of overdiagnosis by improving individualised\u00a0treatment to reduce overtreatment.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Every year the National Health Service in the\u00a0United Kingdom\u00a0spends \u00a396 million\u00a0on its breast screening programme. Despite\u00a0a\u00a0commissioned report\u00a0by an eminent physician, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_s2mail":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[1],"tags":[16,27,32,54,58,80],"class_list":["post-2127","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-breast_cancer","tag-controversy","tag-diagnosis","tag-journal_article","tag-mammography","tag-screening"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.0.1 - aioseo.com -->\n\t<meta name=\"description\" content=\"Every year the National Health Service in the United Kingdom spends \u00a396 million on its breast screening programme. 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