Breaking News
April 25, 2019 - Healthy meal kits can boost children’s long-term health
April 25, 2019 - Designing an inexpensive surgical headlight: A Q&A with a Stanford surgeon
April 25, 2019 - States Weigh Banning A Widely Used Pesticide Even Though EPA Won’t
April 25, 2019 - Integrator complex proteins are crucial for healthy brain development in fruit flies, study finds
April 25, 2019 - Measles vaccination rates are a ‘public health time bomb’
April 25, 2019 - Maths made easier for scientists students who shun the subject wins award
April 25, 2019 - Researchers decode how cancer drug works in brains of Parkinson’s disease patients
April 25, 2019 - Smarter Brain Cancer Trial Comes to Columbia
April 25, 2019 - Researchers Seek Sage Advice Of Elders On Aging Issues
April 25, 2019 - New chemical synthesis strategy leads to identification of novel, simpler derivatives
April 25, 2019 - Vanderbilt investigators discover link between vascular biology and eye disease
April 25, 2019 - Feces transplantation is effective and provides economic benefits
April 25, 2019 - Eisenhower Health first in Southern California to offer new lung valve treatment for COPD/emphysema
April 25, 2019 - Johns Hopkins researchers uncover role of neurotransmitter in the spread of aggressive cancers
April 25, 2019 - Porvair Sciences offers highly effective P3 microplate for biological sample clean-up
April 25, 2019 - Air pollution increases risk for respiratory hospitalization among childhood cancer survivors
April 25, 2019 - We are sitting more! How bad is that?
April 25, 2019 - Majority of stroke survivors not screened for osteoporosis, despite increased risk
April 25, 2019 - ADHD Screening: MedlinePlus Lab Test Information
April 25, 2019 - Cellular alterations increase vulnerability of obese and diabetic individuals to infection
April 25, 2019 - Association Insurance Pushes On Despite Court Ruling
April 25, 2019 - Traditional and e-cigarette users may be more receptive to smoking cessation interventions
April 25, 2019 - Delving into tumor’s cellular lineage may offer clues for customized therapies
April 25, 2019 - Two studies uncover brain mechanisms underlying decision making process
April 25, 2019 - Cardiometabolic Risk Better ID’d in Children Reclassified to Higher BP
April 25, 2019 - How the obesity epidemic is taking a toll on our bones and joints
April 25, 2019 - E-cigarettes contaminated with dangerous microbial toxins
April 25, 2019 - Researchers document specific characteristics of storefront tobacco advertisements
April 25, 2019 - Oncotype DX-guided treatment could reduce cost for breast cancer care, study suggests
April 25, 2019 - Predicting whether a patient will benefit from chemotherapy
April 25, 2019 - New review highlights how lifestyle affects our genes
April 25, 2019 - Study provides evidence that blood tests can detect Alzheimer’s risk
April 25, 2019 - Computer program mimics natural speech using brain signals from epilepsy patients
April 25, 2019 - Physicians turning to antibiotic alternatives for long-term acne treatment
April 25, 2019 - Preschool Is Prime Time to Teach Healthy Lifestyle Habits
April 25, 2019 - Study finds insidious and persistent discrimination among physician mothers
April 25, 2019 - Newly identified skin-gut communication helps illuminate link between food allergy and eczema
April 25, 2019 - Thiazide use linked with reduced risk of low energy fractures in people with Alzheimer’s
April 25, 2019 - Some women are biologically more resilient than others to PTSD
April 25, 2019 - The Current issue of “The view from here” is concerned with Partnerships and Alliances
April 25, 2019 - Imaging method reveals long-lived patterns in cells of the eye
April 25, 2019 - Podcast: KHN’s ‘What The Health?’ The Abortion Wars Rage On
April 25, 2019 - Prolonged exposure therapy is more effective in treating veterans with PTSD, alcohol use disorder
April 24, 2019 - Our artificial cornea breakthrough could lead to self-assembling organs
April 24, 2019 - A Stanford black, female, gay surgery resident speaks out
April 24, 2019 - Donna Lynne on Extreme Sports, Lessons From the '60s, and Taking CUIMC to the Next Level
April 24, 2019 - Pain Clinics’ Doctors Needlessly Tested Hundreds Of Urine Samples, Court Records Show
April 24, 2019 - Researchers uncover potential clue to halt destruction of nerve cells in people with ALS
April 24, 2019 - Study uncovers reasons for poor mental health in bisexual people
April 24, 2019 - Screenings, interventions, and referrals can help adolescents overcome substance abuse
April 24, 2019 - Febrile seizures following vaccination are self-resolving and not dangerous
April 24, 2019 - Flow-UV inline UV-Visible spectrometer monitors dispersion in real time
April 24, 2019 - Rates of Marijuana Use in Cancer Patients on the Rise in U.S.
April 24, 2019 - Versatile drug may protect baby from hazards of intraamniotic infections
April 24, 2019 - Financial transparency may diminish trust in doctors, new study finds
April 24, 2019 - Calling all Riders: Velocity Extends Free Registration 
April 24, 2019 - The Homeless Are Dying In Record Numbers On The Streets Of L.A.
April 24, 2019 - Researchers use brain scans to provide better understanding of unconscious bias
April 24, 2019 - Blocking BRAF ubiquitination may be an effective treatment approach in melanoma
April 24, 2019 - Simple mobility test helps predict hospital readmission in elderly heart attack patients
April 24, 2019 - Novel fluorescence imaging system helps surgeons remove small ovarian tumors
April 24, 2019 - Uncovering the Structure of HIV Integrase to Inform Drug Discovery
April 24, 2019 - Medical Marijuana Use Rising Among Cancer Patients
April 24, 2019 - Artificial intelligence approach optimizes embryo selection for IVF
April 24, 2019 - Doctor or detective? Sleuthing mysteries in medical school
April 24, 2019 - CUIMC Community Gives Blood During Spring 2019 Columbia University Blood Drive
April 24, 2019 - Americans Overwhelmingly Want Federal Protections Against Surprise Medical Bills
April 24, 2019 - Making Laboratories More Efficient with the Most Modern LIMS on the Market
April 24, 2019 - Treating cancer patients with personalized, combination therapies improves outcomes
April 24, 2019 - Researchers engineer new molecules to help stop lung cancer
April 24, 2019 - Acupuncture can be a wonderful tool for preventing number of diseases
April 24, 2019 - Daily life disability before hip replacement may predict poor post-operative outcomes
April 24, 2019 - Study finds involuntary staying in housing estates to be a potential health risk
April 24, 2019 - Older kidney disease patients starting dialysis die at higher rates than previously thought
April 24, 2019 - Time-restricted eating shows promise for controlling blood glucose levels
April 24, 2019 - Ambiguous genitalia in newborns may be more common than previously thought
April 24, 2019 - Research provides important insight on the brain-body connection
April 24, 2019 - In 10 Years, Half Of Middle-Income Elders Won’t Be Able To Afford Housing, Medical Care
April 24, 2019 - Researchers study how E. coli clones have become major cause of drug-resistant infections
April 24, 2019 - Bacterial and fungal toxins found in popular electronic cigarettes
Screening does not reduce breast cancer mortality

Screening does not reduce breast cancer mortality

image_pdfDownload PDFimage_print

Fewer and fewer women die from breast cancer in recent years but, surprisingly, the decline is just as large in the age groups that are not screened. The decline is therefore due to better treatment and not screening for breast cancer.

This is shown by a major Danish-Norwegian study, Effect of organized mammography screening on breast cancer mortality: A population-based cohort study in Norway, which has just been published in the scientific journal International Journal of Cancer.

In the study, the researchers followed all Norwegian women aged 30-89 and identified those who developed breast cancer in the period 1987-2010, before subsequently comparing the number of deaths before and after the screening program was introduced.

As Associate Professor Henrik Støvring from Aarhus University, Denmark, notes, the result does not favour the breast cancer screening program. This conclusion can also be transferred directly to Denmark (and elsewhere), where all women aged 50-69 are offered mammography screening – which is an X-ray examination of the chest – every second year. The Danish screening program was progressively introduced from the early 1990s and was offered nationally to everyone from 2007, three years after the Norwegians, who have supplied data for the Danish-Norwegian research project.

“The important result is that we do not find a beneficial effect of breast cancer screening any longer. The original randomized trials examining breast cancer screening were conducted way back in the 1980s, and they showed an effect, but the fact is that the better the treatment methods become, the less benefit screening has,” says Henrik Støvring, who is associate professor at the Department of Public Health with biostatistics and screening programmes as his particular areas of expertise.

Here he points towards one of the paradoxes of screening – the popular but erroneous belief that if breast cancer patients who have been screened ‘live longer’ than other breast cancer patients, then screening works. The problem is that with screening, medical doctors detect cancerous tumors earlier than they would otherwise have done, and thus move the point of diagnosis forward in time. But even if someone who has been screened lives longer as a patient, it is not certain that their life as a whole will be longer. It is important to account for this fact, and the new study shows that screening does not lead to women living longer overall – and this is the study’s most important finding.

“The women who are invited to screening live longer because all breast cancer patients live longer, and they do so because we now have better drugs and more effective chemotherapy, and because we have cancer care pathways, which means the healthcare system reacts faster than it did a decade ago. But it does not appear that fewer women die of breast cancer as a result of mammography screening,” says Henrik Støvring.

He also points out that it is not always beneficial for a woman to be diagnosed with a tiny cancerous growth of e.g. a millimeter in diameter at a mammography. Some of these small nodules are so slow-growing that the woman would have died a so-called natural death with undiagnosed cancer, if she had not been screened.

“Now what happens is these women are instead given a diagnosis which isn’t going to make anyone happier. Such a breast cancer diagnosis both makes life more difficult and costs a lot of money, but does not ultimately make a difference. The problem is that we are not currently able to tell the difference between the small cancer tumors that will kill you and those that will not,” says Henrik Støvring.

Here he addresses the issue of overdiagnosis which is a growing problem in all Western countries where the approach to medicine and examinations is extensive and where national screening programmes are prevalent. A problem that was last week discussed in Copenhagen, Denmark, where 450 researchers from thirty countries attended the Preventing Overdiagnosis 2018 conference.

Even though the research results challenge the current health policy in Denmark, Norway and the rest of the Western world, Henrik Støvring is not in the business of telling Danish politicians that they should stop the national screening program here and now:

“It’s certainly not my task to decide how the research results should be used, but my suggestion would nonetheless be that we should get together and begin to investigate whether it would beneficial to do something other than screening and whether this could have a better effect. If a doctor could instead examine women’s breasts with his or her hands, what is known as palpation, at regular intervals, then we would avoid much of the overdiagnosis,” says Henrik Støvring.

The research results – more information

The study is a cohort study with follow-up of all Norwegian women aged 30-89 in the period 1987-2010.

Tagged with:

About author

Related Articles