Cost of extending the NHS breast screening age range in England

Abstract

Susan Bewley and colleagues examine the clinical and ethical implications of Public Health England’s trial of widening the age limits for breast cancer screening

Effects of awareness of breast cancer overdiagnosis among women with screen-detected or incidentally found breast cancer: a qualitative interview study

“…In the UK, information about overdiagnosis has been included in a leaflet sent out with women’s invitations to be screened since 2013 but concerns remain that the risk of overdiagnosis is not adequately reflected in the information provided to the public by the National Health Service (NHS). 5 In the USA, Canada and Australia, women are generally invited to screening without receiving clear information on overdiagnosis. 6–8 Evidence suggests that most women are still not aware of the possibility of overdiagnosis, with the benefits of screening largely dominating public opinion.…”

“…Overdiagnosis is a difficult concept to communicate and to understand, particularly because women with overdiagnosed cancers cannot be individually identified. In the UK, information about overdiagnosis has been included in a leaflet sent out with women’s invitations to be screened since 2013 but concerns remain that the risk of overdiagnosis is not adequately reflected in the information provided to the public by the National Health Service (NHS) 5. In the USA, Canada and Australia, women are generally invited to screening without receiving clear information on overdiagnosis 6–8.…”

Trial to extend breast cancer screening won’t resume randomisation after pandemic

“…Writing in The BMJ in April 2019 the emeritus professor of obstetrics and women’s health Susan Bewley, medical writer Mitzi Blennerhassett, and freelance editor Mandy Payne said that women only learnt of their inclusion in the trial through a letter with a prebooked screening appointment 1. They also argued that women were not being properly informed of the risks and that the trial “did not meet standards for generating evidence that would be robust enough to inform future policy.”…”

Blatant disregard to proper consent continues in screening programmes

“…The second is the UK NHS breast screening programme AgeX trial, which was started in June 2009 and announced as “likely to be the largest randomised controlled trial ever undertaken in the world,” recruiting millions of women. Efforts to challenge this trial, with its flawed consent process, have met with “siloed, unresponsive and defensive” attitudes 5…”