Breast cancer screening call for over-65s

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The Independent Online
Extending breast screening to older women would save lives. Jeremy Laurance, Health Editor, on the growing tide of medical and lay opinion urging the Government to act.

There is no longer any doubt that screening women over 65 for breast cancer would reduce the death rate from the disease. Evidence from round the world shows that breast screening is effective up to the age of 75 in saving lives.

A Commons motion signed by more than 30 women MPs is calling on the Government to extend the breast screening programme to women aged 65-69. Under the current programme, women aged 50-64 are invited for screening every three years, but after then the invitations stop and it is left to the women themselves to request screening.

The effect of the policy is that many women think the risk of breast cancer falls at 65 and they do not need screening. But the risk of the cancer and the death rate from it rises with age.

The Commons motion received backing yesterday from experts. Professor Ian Fentiman of Guy's Hospital, London, said: "Women over the age of 65 comprise half the cases of breast cancer in Britain and something like 60 per cent of the deaths. If we were to invite them along for screening, at a conservative estimate, we could probably save 2,000 lives a year."

Dr Robin Wilson, clinical trials co-ordinator, said claims by the charity Age Concern that many older women would die each year that the Government delayed extension of the screening service to include them were "probably right". "There should be screening for women over 65 and it would save as many and possibly more lives than screening women under 65," he said.

The aim of a screening service was to save lives, not detect cancers and as the age of women rose there would be a point where it would cease to be effective, Dr Wilson said. "The older women get the more likely they are to get breast cancer but the less likely they are to die of it because they die of other things. They die with breast cancer, not from it."

Baroness Jay, the junior health minister, said the Government had spent pounds 10m on improving breast cancer services since the election and was awaiting the outcome of pilot studies on extending screening to older women which would not be available for two years.

"We are committed to improving breast cancer services and we will certainly look at all the evidence we have to make sure that we improve them even more," she said on BBC Radio 4's Today programme.

However, Dr Wilson said the three pilot studies - in Nottingham, Leeds and Brighton - were not designed to test the effectiveness of screening in older women, which is accepted, but to assess the logistics of doing so.

Critics say the Government's refusal to act until the results of the pilot studies are available in two years' time is a delaying tactic to save money. Dr Wilson said: "It may be possible to review the initial results of the pilot studies early because by then there may be sufficient evidence on which to plan the extension of screening."

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