For every life saved by Norway's Breast Cancer Screening Programme, five women are over-diagnosed, and have to go through an operation to remove a tumour that otherwise never would have caused problems.
The Norwegian government spends NOK 574 million per screening round to check women between the age of 50 and 69 for breast cancer. An ongoing debate between Norwegian and international researchers and doctors considers the wisdom of offering periodic breast cancer screenings.
On task from the Ministry of Health and Care Services, the Research Council of Norway has done a research-based evaluation of the country's Breast Cancer Screening Programme.
Disparity in research results
The evaluation was led by Professor Roar Johnsen at the Norwegian University of Science and Technology. Together with NTNU postdoctoral fellow Signe Opdahl and the rest of the steering committee, they have gone through all studies done on mammograms in Norway since 2008.
The conclusions of these studies, however, are inconsistent. One report shows that mammograms have reduced the amount of cancer deaths by 10 per cent, while another claims as much as 36 per cent. The evaluation that is now being presented is based on all of these different studies.
Uncertainty in the numbers
Here are a few of the conclusions in the evaluation:
Achieving the goal of the Breast Cancer Screening Programme
"The goal of the Breast Cancer Screening Programme was to reduce breast cancer mortality rates by 30 per cent. Depending on how you look at it, our estimates show that this goal may have been reached. But it has taken a huge toll in the form of overdiagnosis," says Johnsen.
In 2013, Swiss authorities were advised to end their breast cancer screening programme, while England was advised to continue theirs in 2012. Most Western countries have some kind of screening programme available.
Up to each individual to decide
"One challenge we face is that if a small tumour that is most likely benign is discovered, we can't take the chance of not treating it. This means that women have to go through unnecessary cancer treatment, with all of the social and personal costs that entails. More money should be given to research so that we have more knowledge about which tumours do and do not need treatment. Each individual woman needs to consider the pros and cons from her side when she decides if she wants to participate in the Breast Cancer Screening Programme," says Johnsen.
About three quarters of women between 50 and 69 years of age choose to participate in screening. The evaluation was given to the Norwegian Minister of Health and Care Services Bent Høie on 5 June.
"We have now presented the basis for a political decision," Johnsen concludes.
Materials provided by The Norwegian University of Science and Technology (NTNU). Original written by Anne Sliper Midling. Note: Content may be edited for style and length.
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