WOMEN who missed their routine breast cancer screening due to a computer error should “carry on with their lives” and not attend catch-up appointments as the programme can do “more harm than good”, a group of doctors has said.
In a letter to the Times, 15 medical professionals said women aged 70 to 79 offered the checks “would be well advised to look this gift horse in the mouth” and only seek help if they notice any symptoms.
Lead signatory Susan Bewley, professor of women’s health at King’s College London, writes alongside the likes of Michael Baum, professor emeritus of surgery at University College London, to warn that women should not be subjected to worry or “fear-mongering”.
The letter argues: “The breast cancer screening programme mostly causes more unintended harm than good, which is slowly being recognised internationally.
Many women and doctors now avoid breast screening because it has no impact on all-cause death.
“It unquestionably increases mastectomies,”
they wrote, adding: “Although counterintuitive, catching some things that look like cancer down a microscope [before it exists] can be too early and unnecessary.”
The warning comes after Health Secretary Jeremy Hunt revealed that 450,000 women aged 68 to 71 had not been invited to their final routine breast cancer screening because of a computer blunder.
COMMENT: The sheer scale of the problem is simply shocking
By Philippa Whitford
ON Wednesday the UK Health Secretary, Jeremy Hunt, announced that an estimated 450,000 women in England were not invited to their final breast screening mammogram, between 68 and 71 years of age, as a result of an IT failure. The sheer scale of the problem is shocking.
However, at this time, the focus must be on contacting the 300,000 women estimated to still be alive to offer them a mammogram if appropriate (some women will now be almost 80 and there is an increased risk of them undergoing treatment for a slow growing lesion that would never harm them).
Tracking everyone down will be a major undertaking to ensure, as the Secretary of State promised, that all the women affected receive a letter by the end of May.
The Scottish Breast Screening Service uses a totally different IT system so there is no impact on women who have undergone their screening in Scotland. However, there may be some women who moved to Scotland in their late 60s or early 70s and missed out on their last mammogram before leaving England. The challenge for NHS Scotland is, therefore, working with Public Health England to identify and contact these women and offer them mammograms at their local screening unit.
Despite the Department of Health being aware of the screening problem since January, it appears that liaison with the devolved health services has only just started. The Secretary of State was unable to give any idea of the numbers of women who have moved to the Devolved Nations or, indeed, retired to Europe.
Jeremy Hunt has promised that all catch-up mammograms will be carried out within the next six months, but carrying out thousands of extra mammograms will certainly put a strain on breast screening services as there is a significant shortage of both radiographers, to take the mammograms, and breast radiologists to report them. While he has promised funding to help screening services carry out this work, it will be a real challenge to avoid impacting on the normal screening service for women aged 50-70years.
It is natural that older women with breast cancer will question if it might have been picked up earlier had they undergone their final screening mammogram, while those who have lost a loved one will inevitably wonder if it could have been avoided. Jeremy Hunt has promised a review of all deaths in this age group to try and get answers but this will take a long time.
Early detection of cancer provides the best chance of a positive outcome so it is important this failure to recall women for their final mammogram does not deter others from taking up their normal screening invite.
Philippa Whitford is a Scottish National Party politician and surgeon.
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