Screening – scare vs save?

A recent paper published in the BMJ has suggested that breast cancer screening is not responsible for reductions in breast cancer mortality. The study compared neighbouring countries with different screening levels, and found little effect of breast cancer screening.  Instead better treatment and improvements in health systems were found to be more likely to have contributed to the falling death rates.

However those working in the NHS Cancer Screening Programmes claim that screening does save lives, and the independent Advisory Committee on Breast Cancer Screening estimates breast screening saves 1,400 lives each year.

As part of the greater focus on public health and preventative health care there needs to be a reassessment of the screening offered within the NHS and how this can be done most efficiently.  As a national public health system, the NHS offers far less screening than many private systems, and an analysis needs to be done of the value of different types of screening. The value of screening is both in term of cost savings for the future NHS, and the value to the individual, taking into account the likelihood of a true result, and the chance of false positives, which can be very upsetting.

In addition a rationalisation of health screening should be considered with screening for different diseases and lifestyle advice brought together into one consultation.  We welcome the development of the NHS Health Check, which includes various types of health screen, but feel that there are other areas that could be assessed for inclusion in this check, such as alcohol consumption.

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