Saturday, 1 March 2014

News: Increasing UK women fear needless mastectomies

Mammograms have always been a hot topic in breast cancer news. In the UK, there is a number of women who started shunning mammograms for fear of being over-diagnosed and thus going through needless mastectomies. Read about this debate as it relates to you, but never stop or start a medical practice without consulting with your physician. There is still 2 sides to each news story.

The story from the UK based Daily News:

"The figure was calculated as of March 31, 2013, and is lower than the 77 per cent coverage achieved at the same point in 2012 and the 77.2 per cent in 2011.
The NHS Cancer Screening Programme says 70 per cent of women should be screened as a minimum. In London, coverage was 68.7 per cent and it has never achieved the target figure.
Significantly, latest figures show a fall for the second year running in annual uptake - the proportion of women invited for screening in the most recent year.

In 2012/13, 72.2 per cent of women aged 50 to 70 (about 1.68 million women) took up their invitation, around 21,000 fewer compared to the previous year.
The uptake in 2011/12 was 73.1 per cent, down from 73.4 per cent in 2010/11.
Under the NHS screening programme, women are invited for three-yearly mammograms or breast X-rays between the ages of 50 and 70 years. The age limits are being extended to 47-73.

The continuing decline in women getting checks will raise fears of a loss of confidence in screening after controversy over the risks and benefits.
A major review into the NHS screening programme in 2012 by Professor Sir Michael Marmot found screening saves around 1,300 lives each year - but also leads to some 4,000 women having treatment they never needed.

It also revealed that one per cent of all women going for NHS screening over 20 years would end up ‘overdiagnosed’ with cancer.
This means they had cancer under the microscope but would not have had symptoms during their lifetime because the cancers were slow growing or non-aggressive.

As a result, leaflets informing women about the need to have a mammogram, have been changed to reflect these uncertainties.

From last September the invitation letter tells the woman it’s ‘your choice’ whether or not to have screening, while the leaflet says some women will be diagnosed and treated for breast cancer that would otherwise never have been found or caused them harm.

The leaflet spells out in bold type: ‘Overall, for every woman who has her life saved from breast cancer, about three women are diagnosed with a cancer that would never have become life-threatening.’
‘This adds up to about 4,000 women each year in the UK who are offered treatment they did not need,’ it says.

There were fears some women would be deterred from attending for an X-ray by learning about the drawbacks which could make the programme, costing an estimated £96 million a year in England, less effective.

If participation by the women targeted falls below 70 per cent, it becomes less cost effective because it is more expensive to run per cancer detected and treated.

HSCIC Chief Executive Alan Perkins said: ‘The figures point to a fall in the proportion of women who are taking up their screening invitation for the second year running - and while this is a relatively small fall in percentage terms - it is nevertheless a vital piece of information for health professionals and the public.’

Dr Caitlin Palframan, Senior Policy Manager at Breakthrough Breast Cancer said: ‘While it is disappointing to see a slight decline in the proportion of women attending their screening appointments, it is encouraging that the numbers remain high. In 2012-13, almost two million women in England were screened.
‘We believe that screening saves lives, and it’s estimated that screening will prevent 25 women a week in the UK dying from breast cancer.
‘However, there are some risks associated with breast screening and so it’s very important that each woman makes an informed choice as to whether they wish to attend.’

Professor Julietta Patnick, Director of the NHS Cancer Screening Programmes, said: ‘We are disappointed to see that the latest figures for 2012-13 show a slight fall in the number of eligible women, aged 53 to 70, taking up their breast screening appointments.
‘Early detection and regular screening saves lives and we encourage women to attend their appointment. Women are routinely screened in England between the ages of 50 to 70.
‘Women aged 71-74 are not routinely invited for screening, and those aged 71-73 are being invited as part of a research trial currently being carried out by Public Health England.
‘This trial is looking at the benefits and harms of screening women aged 71-73, and also of screening women aged 47-49.’"

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