Benefits and harms of breast cancer screening programs

31/01/2018

Many countries worldwide invite women of a certain age and at certain intervals to take part in breast cancer screening programs. The reason behind these programs is that they should help lower the mortality rate in breast cancer patients. Usually, these programs take place every one or two years. The importance of screening programs, however, is highly debated and widely discussed.

A recent study, for example, declares that annual breast cancer screening with mammography starting at age 40 results in a nearly 40% reduction in breast cancer-specific deaths compared with screening at less frequent intervals.1 Another recent study, however, shows that breast screening is unlikely to reduce breast cancer mortality or lead to less invasive treatment, but rather risks over treating women.2

Benefits

Harms

Screening may give an indication of cancer before any symptoms develop

Screening may miss a number of cancers and provide false reassurance: no cancer screening test is 100% accurate

Screening may find cancer at an early stage when treatment is more likely to be curative, increasing the chance of recovery

Screening may lead to false positive findings that can cause women unnecessary fear of death

Screening may lead to fewer breast cancer-specific deaths

Screening may lead to over diagnosis because harmless lesions are also detected and unnecessarily treated

Screening mammograms acquired with new systems expose women to very small dose levels

Screening mammograms, like all X-rays, expose women to radiation dose, which could increase the risk of cancer

The list, of course, is not complete. There are many more arguments for and against mammography screening. But what should one believe? Do the pros outweigh the cons – or vice versa? Whatever the opinion: In the end it’s every single life that could be saved that matters.

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