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Millions of women invited for breast cancer screening will now get a leaflet explaining the drawbacks for the first time.The old leaflets were condemned as ‘patronising’ by experts because they exaggerated the benefits and did not spell out the risks.
As a result, women could not make a properly informed choice about whether screening was right for them.
Millions of women invited for breast cancer screening will now get a leaflet explaining the drawbacks for the first time. This will help them make an informed decision about whether to have the screening
Mounting controversy over whether women were getting the full picture led to a major review into the NHS screening programme by the internationally recognised public health expert Professor Sir Michael Marmot.
The review concluded screening saves around 1,300 lives each year, but leads to 4,000 women having treatment for cancer they never needed.
It found 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.
The review led to a recommendation last year from Professor Sir Mike Richards, former National Clinical Director for Cancer, that the leaflets be updated.
In future women should be given ‘clear and accessible’ information before they go for a breast X-ray, or mammogram, so they could make up their own minds.
From today the NHS Cancer Screening Programmes will begin to use a new invitation letter and accompanying leaflet for women over 50 invited for screening every three years.
The 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 old leaflets were condemned as 'patronising' by experts because they exaggerated the benefits and did not spell out the risks. Image shows breast cancer cells
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 is because at present doctors cannot accurately identify cancers that will shorten life expectancy.
The leaflet says researchers are trying to find better ways to tell which women have breast cancers that could be fatal and which do not.
Statistics from the review are included, with women being told that 4,000 of those going for screening each year will be offered treatment that’s unnecessary.
Other risks include the worry and distress affecting women given an abnormal result that turns out to be wrong.
The leaflet also says having a breast X-ray every three years for 20 years will itself very slightly increase the chance of cancer over a women’s lifetime.
And cancer will be missed in about one in 2,500 women screened, according to the leaflet.
Following a public consultation, the leaflet was drafted and tested with a Citizen’s Jury, in which 25 women were asked how they would like the information about the benefits and risks of breast screening to be presented.
Under the NHS screening programme, women are invited for three-yearly mammograms between the ages of 50 and 70 years. The age limits are being extended to 47-73.
Almost two million women in the UK are screened each year.
There have been fears some women will 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.
Screening saves around 1,300 lives each year, but leads to 4,000 women having treatment they never needed. This is because doctors cannot tell whether cancer cells will become a problem or not
Professor Julietta Patnick, director of the NHS Cancer Screening Programmes, said: ‘We believe that the leaflet now available to women provides a balanced assessment of the benefits and risks of breast screening and will support them as they decide whether to attend their screening appointment.’
Professor Sir Michael Marmot, chair of the independent breast screening review panel, said: ‘My review of breast screening concluded that screening contributes to reducing deaths from breast cancer in women.
‘However, there are potential risks as well as benefits associated with breast screening, and it is important women are given information that is clear and accessible before they go for a mammogram.’
Sean Duffy, National Clinical Director for Cancer Services, said: ‘These new materials were developed following rigorous consultation with experts, and with women from the target audience.
‘The new materials will provide each woman with the clear, accurate information she needs to make a personal decision about whether to attend for breast screening.
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