We need to talk about breast cancer screening (part 2)

Thursday, June 26th, 2014 | Kate Sloane | 5 Comments

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Editor note: This is Part 2 of a two-part blog by Dr Caroline Shaw and Associate Professor Diana Sarfati on breast cancer screening. In Part 1 they looked at the contested research around breast cancer screening. In today’s Part 2 they explore the implications for New Zealand. As Editor’s, we agree with Shaw and Sarfati that screening beneath the age of 50 should stop and the quality and honesty of communication to women must improve. We would also go one step further and argue that the cost-effectiveness of breast cancer screening should be re-evaluated, for optimistic and pessimistic scenarios. A media release also accompanies this blog.

Dr Caroline Shaw and Associate Professor Diana Sarfati

What do we do with the conflicting information on breast cancer screening?

Assoc Prof Diana Sarfati and Dr Caroline Shaw

Assoc Prof Diana Sarfati and Dr Caroline Shaw

Sorting through the information about breast cancer screening is difficult. There are highly experienced and knowledgeable screening experts on both sides of the debate and both sides make some cogent arguments. There is disagreement about the validity of evidence from the individual randomised controlled trials (RCTs), about whether improvements in treatment have had an impact on screening effectiveness and about the level of over-diagnosis from screening. In some cases researchers are looking at the same screening studies and concluding very different things. In others, they disagree about the best methods and data to use to examine an issue. Polarisation of views is pretty typical in screening; however it does make it difficult to know where the truth lies as positions become entrenched.

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We need to talk about breast cancer screening (part 1)

Monday, June 23rd, 2014 | Kate Sloane | 1 Comment

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Editor note: This week Dr Caroline Shaw and Associate Professor Diana Sarfati consider the pros and cons of breast cancer screening, in light of the growing controversy (mostly in the northern hemisphere) about the possibility that the benefits of breast cancer screening are (much) less than previously thought due to over-detection and other issues. In today’s Part 1 blog, Caroline and Diana outline the issues. In the Part 2 blog (appearing on Thursday), they aim for more specific recommendations.

Dr Caroline Shaw and Associate Professor Diana Sarfati

Breastscreen AotearoaPopulation screening attracts controversy. For breast cancer screening there is an ongoing controversy being played out in the international literature related to the absolute fundamental rationale of screening; should we be screening for breast cancer at all? This is a big deal, given that most developed countries have invested hundreds of millions of dollars in the human and technical infrastructure for screening in the last few decades. BreastScreen Aoteroa, for example, costs over $50 million annually. Continue reading