New research proves risk of death cut by screening

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An attempt to settle the controversy over breast screening has been made by researchers who reported the results of a 15-year study yesterday which showed that screening cut the risk of death from the disease by 21 per cent.

An attempt to settle the controversy over breast screening has been made by researchers who reported the results of a 15-year study yesterday which showed that screening cut the risk of death from the disease by 21 per cent.

Doctors in Sweden, who analysed the results of four trials involving 247,000 women, said the findings, published in The Lancet, should help to end doubts about whether screening was worthwhile.

However, in the light of the row over the delay in winning NHS approval for the breast-cancer drug Herceptin, some specialists have questioned whether the £37m annual cost of screening in the UK would save more lives if it were spent on improving breast cancer treatment.

The controversy began two years ago after two Danish researchers analysed seven trials of breast screening which suggested no benefit from the procedure. A follow-up article published in The Lancet last October confirmed their earlier conclusion.

The finding started a furore in the US where the Physicians Data Query Board, a body of experts which advises the National Cancer Institute, said in January that "mammography may not be beneficial". This prompted an angry response from the American Medical Association and the American Cancer Society which were among 10 signatories to a full-page advertisement in The New York Times extolling the benefits of screening.

In the latest study, Lennarth Nystrom and colleagues from Umea University found a benefit in screening women over 55 years old although not younger women. They rejected the two Danish studies as "misleading and scientifically unfounded." In a commentary on the finding, Karen Gelmon and Ivo Olivotto from the British Columbia Cancer Agency said it confirms that "screening mammography has a real but modest effect in decreasing mortality from breast cancer".

However, they add: "Since breast cancer accounts for only about 4 per cent of all deaths annually, even a 21 per cent reduction in breast cancer mortality is barely measurable."

The benefits of breast screening are likely to be backed by the World Health Organisation which is to release the findings of its own investigation on the issue on Monday.

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