BREAST screening does women more harm than good and health bosses should consider axing it to save the NHS money, MSPs will be told today.
Respected public health expert, Dr Helene Irvine, said the programme was a waste of resources and pointed to research from Switzerland that mammography appeared to be preventing only one death for every 1,000 women screened.
In evidence to Holyrood’s Health and Sport Committee as part of a review of preventative health spending, Dr Irvine said: “Is the [Breast Screening Programme] worth continuing with? Isn’t a reasonable alternative relying on investigating and treating real lumps in women of all ages when they appear rather than proactively pursuing three quarters of a million women in that age group to undergo a procedure every three years that is unpleasant and exposes them to unnecessary radiation, for a handful of ‘wins’ that creates a large false positive rate?”
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Dr Irvine is employed as a public health consultant by NHS Greater Glasgow and Clyde but submitted the paper in a professional capacity, independent from the health board. She is also due to give evidence to the committee in person today.
Dr Irvine said that no area of preventative spending, with the exception of immunisations among pre-school children, should be “regarded as sacred” amid the financial pressures facing the NHS.
Dr Irvine said screening programmes, smoking cessation and alcohol brief interventions were the areas of public health spending which “should be reviewed in the first instance”. She added: “We need to prioritise responding to the genuine needs of patients in real time over the theoretical potential to prevent problems in the future.”
It has been estimated that for every life saved by breast screening, another three women will be diagnosed with a “cancer” that would never have become life-threatening and subjected to needless and potentially harmful tests and treatments, such as surgery and radiotherapy, as a result.
A 2014 Swiss study found an even lower benefit to harm ratio. Dr Irvine said: “The ‘evidence’ simply did not back up the global consensus of other experts in the field suggesting that mammograms were safe and capable of saving lives. On the contrary, mammography appeared to be preventing only one death for every 1,000 women screened, while causing harm to many more.”
Breast screening is offered to all women aged 50 to 70 in Scotland but take up is higher among affluent women despite overall cancer incidence and death rates being much higher in deprived communities, meaning that screening also "contributes to inequalities in health" said Dr Irvine.
Around 1000 women a year in Scotland die from breast cancer.
Mary Allison, Breast Cancer Now’s Scotland director, said: “Were it not for the Scottish Breast Screening Programme it is probable that number would be far higher, especially given that we also know only around half of women in Scotland check themselves regularly for the signs and symptoms of breast cancer.”
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Health Secretary Shona Robison said: “Screening programmes in Scotland, as with the other UK countries, are introduced on the basis of recommendations from the UK National Screening Committee. The NSC makes recommendations based on all the most recent evidence and regularly reviews recommendations.”
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