Breast cancer: screening mammograms don't necessarily reduce fatality rates

Two studies published simultaneously in the US and Great Britain call into question the efficiency of screening mammograms for breast cancer. These studies now join a debate that has been raging between specialists around the world.

The first study, led by Professor Philippe Autier from the Institute of Global Public Health, a joint health research initiative of Strathclyde University and the Lyon-based International Prevention Research Institute (iPRI), and Professor Peter Boyle, Director of the University of Strathclyde Institute of Global Public Health at iPRI, was published in the Journal of the Royal Society of Medicine.

He and his team used the results from an infamous study conducted in Sweden in the 60s and 70s that has served as a basis for the implementation of screening mammogram procedures for breast cancer in several countries, including England. The study had concluded that early screening could prevent 20-25% of fatalities due to breast cancer.

Prevention policies worth revising

After analysis, today's scientists declared that the methodology of the study was wrong and that those figures were much too optimistic. In fact, they believe that any reduction of deaths is probably less than 10% and, according to Professor Richard Sullivan from the Institute of Cancer Policy, King's College London, "At some point Britain will have to re-review its policy and this will be one of the pieces. My feeling is, give it another two years and Britain may need to constitute another group in 2017. The screening debate is far from over."

This stance is not shared by all though. Professor Julietta Patnick, Director of the NHS Cancer Screening Programmes, stated in 2012 that "inviting women aged 50-70 for screening reduces mortality from breast cancer in the population invited by 20% and saves an estimated 1,300 lives a year in the UK."

16 million test subjects

The second study was led by Professor Richard Wilson from Harvard, who, with his team, analyzed data on more than 16 million women aged over 40 who resided in 547 different counties and reported to the SEER (Surveillance, Epidemiology and End Results) during the year 2000. Of those women, 53,207 were diagnosed with breast cancer that year and followed for the next 10 years. Analysis of the data was performed between April 2013 and March 2015.

The results of the study, published in the JAMA Internal Medicine journal, confirm those of the first study. According to the study, "A 10-percentage point increase in screening is associated with a 16% mean increase in breast cancer incidence. However, there is no commensurate change in 10-year breast cancer mortality."

Even though the debate is ongoing between supporters of screening mammograms and skeptics, the number of studies that back up the efficiency of screening remains higher.


 

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