The breast screening programme and misinforming the public

Abstract

The information provided to the public by the NHS Breast Screening Programme has been criticized for lack of balance, omission of information on harms and substantially exaggerated estimates of benefit. These shortcomings have been particularly evident in the various invitation leaflets for breast screening and in the Programme's own 2008 Annual Review, which celebrated 20 years of screening. The debate on screening has been heated after new data published in the last two years questioned the benefit and documented substantial harm. We therefore analysed whether the recent debate and new pivotal data about breast screening has had any impact on the contents of the new 2010 leaflet and on the 2010 Annual Review. We conclude that spokespeople for the Programme have stuck to the beliefs about benefit that prevailed 25 years ago. Concerns about over-diagnosis have not been addressed either and official documents still downplay this most important harm of breast cancer screening.

Figure 1

Incidence rates of invasive breast cancer (DCIS not included) in the UK 1975–2007. Background incidence projected from the pre-screening trends (dotted lines) (see http://info.cancerresearchuk.org/cancerstats)

Figure 2

Mastectomy rates in women aged 50–69 years in Denmark. StatBank Denmark (see www.statistikbanken.dk)

Figure 3

Mastectomy rates in women aged 70–85 years in Denmark. StatBank Denmark (see www.statistikbanken.dk)

Figure 4

Mastectomy rates in women aged 30–49 years in Denmark. StatBank Denmark (see www.statistikbanken.dk)