Government-Run Screening Programs Might Lead To Overtreatment Of Breast Cancer, Danish Study Says

Main Category: Breast Cancer
Article Date: 14 Jul 2009 - 7:00 PDT

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One in three breast cancer patients identified in certain nations' public screening programs might have undergone unnecessary treatment, according to a study published Friday in BMJ, the AP/Google.com reports. For the study, Karsten Jorgensen and Peter Gotzsche of Copenhagen's Nordic Cochrane Centre examined breast cancer trends at least seven years before and after the launch of government-run screening programs in parts of Australia, Canada, Great Britain, Norway and Sweden. The programs usually test women ages 50 to 69.

According to the AP/Google.com, effective screening programs should detect more cases and result in a decline in advanced cancer cases detected in older women, whose cancers would have been caught in earlier screenings. However, the study found that the national screening systems simply detected thousands more cases than previously identified.

Experts say that overtreatment of cancer occurs wherever there are widespread screening programs, including in the U.S. Some cancers develop too slowly to ever cause symptoms or death, the AP/Google.com reports. However, it is impossible to determine which cancers will be deadly, so all detected cases are treated. Jorgensen said that there is "significant harm in making women cancer patients without good reason" and that the "information needs to get to women so they can make an informed choice."

Gilbert Welch of the VA Outcomes Group and the Dartmouth Institute for Health Policy and Research wrote in an accompanying editorial that although mammography "undoubtedly helps some women," it "hurts others." Welch wrote that it is "one of medicine's 'close calls,' ... where different people in the same situation might reasonably make different choices."

Britain's National Health Service recently stopped distributing breast cancer screening pamphlets in response to criticism that they included too little information on cancer overtreatment. Laura Bell of Cancer Research UK said that although the organization still urges women to be screened, it is important that they be made aware of potential benefits and harms (Cheng, AP/Google.com, 7/9).

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