Friday, April 3, 2015

The Swiss Medical Board does not recommend screening mammography

Screening advocates (including those who stand to lose financially, professionally or politically from discontinuation of screening), most certainly did not take this report soberly and sitting down: "The report caused an uproar and was emphatically rejected by a number of Swiss cancer experts and organizations, some of which called the conclusions 'unethical.' ”
The Swiss Medical Board's report was made public on February 2, 2014 (www.medical-board.ch). It acknowledged that systematic mammography screening might prevent about one death attributed to breast cancer for every 1000 women screened, even though there was no evidence to suggest that overall mortality was affected. At the same time, it emphasized the harm — in particular, false positive test results and the risk of overdiagnosis. For every breast-cancer death prevented in U.S. women over a 10-year course of annual screening beginning at 50 years of age, 490 to 670 women are likely to have a false positive mammogram with repeat examination; 70 to 100, an unnecessary biopsy; and 3 to 14, an overdiagnosed breast cancer that would never have become clinically apparent.5 The board therefore recommended that no new systematic mammography screening programs be introduced and that a time limit be placed on existing programs. In addition, it stipulated that the quality of all forms of mammography screening should be evaluated and that clear and balanced information should be provided to women regarding the benefits and harms of screening.

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