Driving down breast cancer screening costs

 In the UK, more women are now being diagnosed with breast cancer, with mortality rates below average when compared to other western countries. However, since the 1980s, breast cancer and its awareness has become a dominant presence throughout the world. Statistics gathered over the past two decades would suggest that breast cancer is caused by environmental factors. North European women have a relatively high probability of developing the disease, along with North Americans and Australians, compared to those from the Mediterranean or the Far East. For example, a Japanese woman born and raised in her homeland will have a very low chance of developing the disease. However, if she was to live in the UK for five years or more, she would have the same probability of developing the disease as a local. While a scientific explanation for this remains absent, the reality is that breast cancer poses a greater threat to women in the UK than some other areas of the world. Recently, breast cancer has dominated the news headlines – from new research, to criticism of the screening process. However, arguably the most important news came in October 2011 with the announcement of an independent review into the NHS mammogram breast screening programme. Led by Professor Sir Mike Richards, national cancer director at the Department of Health, the review aimed to update the current programme with more developed medical devices. According to Cancer Research UK, one in eight women will develop the disease at some point in her life – which is 5,000 more diagnoses a year than a decade before. Despite this, the current NHS breast-cancer screening programme, which allows all women from the age of 50 to have three-yearly mammograms, has been said by some doctors and researchers to do ‘more harm than good’. Peter Gøtzsche, a Danish medical researcher, and director of the independent Nordic Cochrane Collaboration, for example, claims that the procedure harms ten out of every 2,000 women scanned. He has stated that women who do not have the disease are being subjected to a treatment that may damage the breast and increase chances of breast cancer development later in life, costing the NHS more through further treatment. Nevertheless, mammogram screening can save lives because it allows breast cancers to be diagnosed and treated early, lowering mortality rates. That is an established fact, proven by decades of data from the US, Europe and here in the UK. Statistics published in the International Journal of Cancer show that in 1982, the year that the NHS started its breast screening programme, there were over 18,000 mammograms administered with the number increasing thereafter. Mortality from breast cancer has declined steadily to about 12,500 a year and has since stabilised at that level. The UK’s stabilised mortality rate remains above many European neighbours such as Germany and Sweden, suggesting improvement is achievable. However, at present, there are a number of broad issues with the current UK screening programme that need to be addressed. These include:

Age range

A woman’s risk of developing breast cancer dramatically increases from the age of 42. The current UK screening programme only targets women from the age of 50, although this will soon be reduced to 47 – a clear admission of the fact that screening at 50 or over is often far too late to prevent breast cancer becoming fatal. Unfortunately, 47 will be too late for many women as well. Breast cancer is capable of developing in far younger women. Screening should be made available for all women over the age of 18.