Breast cancer checks 'have little impact'

Checks: Women in the UK are invited for screening between the ages of 50 and 70
12 April 2012

Breast cancer screening has had little impact on falling death rates from the disease, according to new research.

Experts compared data from three pairs of European countries and found the countries within each pair experienced a similar fall in death rates.

This was despite a gap of 10 to 15 years between the countries in implementing a breast cancer screening programme.

Northern Ireland was compared with the Republic of Ireland, while the Netherlands was compared with Belgium and Belgium's region of Flanders, and Sweden with Norway.

From 1989 to 2006, deaths from breast cancer decreased by 29% in Northern Ireland and by 26% in the Republic of Ireland, according to the study, published in the British Medical Journal.

Deaths also fell by 25% in the Netherlands and by 20% in Belgium and 25% in Flanders. Sweden deaths were down 16% compared to 24% in Norway.

The researchers, who analysed data on deaths from the World Health Organisation database, concluded: "Countries of each pair had similar healthcare services and prevalence of risk factors for breast cancer mortality but differing implementation of mammography screening, with a gap of about 10 to 15 years.

"The contrast between the time differences in implementation of mammography screening and the similarity in reductions in mortality between the country pairs suggest that screening did not play a direct part in the reductions in breast cancer mortality."

The study was led by a team of researchers from France, the UK and Norway.

They suggested better treatments and improving health systems were more likely to have contributed to falling death rates than screening.

Overall, death rates appeared to have fallen in countries where women had been screened for a considerable time but also in those where women were largely unscreened during the same period.

Women in the UK are invited for screening between the ages of 50 and 70. The programme in England is currently being extended to include those aged 47 to 73.

Breast Cancer Care's clinical nurse specialist, Rachel Rawson, said: "Though this retrospective study comparing breast cancer mortality using three country pairs is interesting it may not take into account all of the factors that might have influenced the results.

"In the UK breast cancer mortality rates have fallen year on year since 1989.

"This reduction is likely to be due to various causes including screening, improved treatment regimes and increased specialisation of care.

"Breast screening remains an effective option for detecting breast cancers as soon as possible.

"We know that early detection of breast cancer may lead to simpler and more effective outcomes and we would encourage women to consider attending routine screening."

Professor Julietta Patnick, director of the NHS Cancer Screening Programmes, said in England the best available evidence shows that women aged 50 to 69 who are regularly screened are less likely to die from breast cancer.

She added: "The World Health Organisation's International Agency for Research on Cancer estimates that there is a 35% reduction in mortality from breast cancer among screened women aged 50- to 69-years-old; and in England, the independent Advisory Committee on Breast Cancer Screening estimates breast screening saves 1,400 lives each year."

A spokeswoman for the Department of Health said: "According to the vast majority of experts, the evidence shows that breast screening reduces deaths from breast cancer.

"The NHS Breast Screening programme is based on the best available evidence and in line with the recommendations of the World Health Organisation.

"Experts estimate that the NHS Breast Screening programme saves the lives of 1,400 women each year and we are extending it to ensure that every eligible woman should receive her first invitation by her 50th birthday."

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