Report Says Breast Screening Saves Lives But Leads to Overdiagnosis

An independent review of breast screening programs in the United Kingdom is making headlines this week, after concluding that mammography saves lives but at a cost. The report was by an independent panel co-commissioned by Cancer Research UK, which says the panel concluded that

“…overall in the UK, having a breast screening programme means that about 1,300 breast cancer deaths are prevented each year. These are cancers that are found and treated earlier than they would have been if we didn’t have a screening programme.

“But also, out of the total of around 15,500 women diagnosed with breast cancer through screening, 4,000 of them are overdiagnosed. So around 1 in 4 of women diagnosed with breast cancer through screening would never have had a problem from their breast cancer if they hadn’t been screened.”

Here in the United States, the Preventive Services Task Force recommends screening every two years for women ages 50 and above, while the American Cancer Society and some others recommend mammograms every year starting at age 40.

As for what the new review says about health care: the panel in the UK concludes:

“Information should be made available in a transparent and objective way to women invited to screening so that they can make informed decisions.”

Here’s what Otis W. Brawley, M.D., chief medical officer, had to say about the report.

Otis Brawley

Otis Brawley, MD, Chief Medical Officer, American Cancer Society

“While this review focuses only on women older than 50 and was based on older studies that used less effective technology, its conclusion is sound: that mammography saves lives but leads to a high proportion of women receiving treatment they did not require; so-called over-treatment.

“We have overwhelming evidence showing that mammography starting at age 40 saves lives and is even more effective in older populations. The data also suggests screening has harms. That’s a part of the message that has often been lost in vigorous efforts to encourage screening.

“The American Cancer Society believes that women should be encouraged to be screened using mammography starting at age 40, but also that clinicians need to tell women about the limitations of the test. So while we should encourage screening, we need to do so in a balanced way, and we also need to respect a woman’s right to make her own decision.”

For more information, see “Can Breast Cancer Be Found Early?” on cancer.org.

About David Sampson

I am the director of medical and scientific communications for the American Cancer Society national home office.
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