The National Health Service UK Breast Screening Programme (NHS BSP) was initiated in1988. All women in Scotland aged 50 and over are entitled to free mammography screening from the National Health Service. Women aged 50 to 70 will automatically be called for screening – women over the age of 70 are eligible but must request screening. Some women assume that as soon as they reach the age of 50, they will be called for screening. This is not the case. The Screening Programme operates over a three yearly cycle so some women will be approaching or just past their 53rd birthday before being called.
Whilst CBCS acknowledges the importance of the NHS BSP, it would be disingenuous not to point out that there is much debate within medical circles regarding the efficacy of screening e.g. how many lives are saved by screening? how much harm is done by screening?
The huge amount of controversy surrounding the national screening programme prompted a major and independent review of breast screening in England in 2012. Lead by Prof Marmot, the Committee published its report in September 2012. The Report acknowledged that it was not a systematic review (i.e. a review of all available evidence) and that its conclusions were based on evidence which was 20 years old. With these provisos, the Marmot Review concluded that for every one life saved from breast cancer through the NHS BSP, three women would be harmed. However, it recommended the retention of the national screening programme. The full report can be downloaded from ibsr-fullreport
Challenge Breast Cancer Scotland neither promotes nor discourages women to attend for screening and defends the right of every woman in Scotland to have access to screening services if she wishes. However, we also acknowledge the right of every woman in Scotland to make an INFORMED CHOICE about taking part in a national screening programme. In order to so, women must be given clear, comprehensive, unbiased and up-to-date information about the benefits and harms associated with screening. In our opinion, the current leaflet “Brest Screening: What you need to know”, falls very far short of this ideal. The current leaflet is at present under consideration for redraft by NHS Health Scotland in consultation with CBCS, Breakthrough Breast Cancer and Breast Cancer Care Scotland.
Nordic Cochrane Centre, a totally independent research and information centre has produced an alternative leaflet to the NHS. This can be accessed at http://www.cochrane.dk/.
For the average woman, making an informed choice on screening is not easy and should not be taken lightly. Many factors will influence a woman’s decision to attend for screening e.g. a family history of breast cancer; a neighbour or friend whose cancer was picked up at screening; an unfounded but nevertheless very real anxiety of breast cancer which could be alleviated by an “all clear” screen; an overestimation of her risk of breast cancer. However, just as many factors may influence a woman’s decision not to attend for screening e.g. the risk of overdiagnosis; the harms of overtreatment; the stress of a false positive result. Neither decision is right or wrong – it is informed CHOICE. Whatever personal decision is made on screening, it should be made with full knowledge of the facts and the utmost consideration of the consequences But this is a personal decision and only the individual woman can assess the risks and the benefits and arrive at that decision.
To read more about the harms and benefits of attending a screening appointment, please Click here