By Sally Crossing – originally published in the SMH.
The great breast cancer screening debate shows few signs of going away, fuelled from time to time by comments of “experts”, mainly epidemiologists, who raise alarm about the perceived harms of screening. Recently, we even heard the reckless equating of the risks of some screening with smoking cigarettes.
People who have been diagnosed with cancer, like myself, think it’s about time our views entered the mix. We also want the dilemma we face better understood.
The main factors considered a “harm” by experts are over-diagnosis and the subsequent over-treatment. Yet until we know which cancers detected by screening will develop into life-threatening ones, how we can possibly say that the risk of harm is significant enough to not participate in a screening?
Let’s stick to the example of breast cancer screening (the only cancer with long-term publicly funded and recorded programs). Why do we fund BreastScreen, which offers women of ages 50-74 regular, free mammograms? The evidence is clear: early detection improves survival and screening, together with improved treatments, has reduced deaths from breast cancer.
Controversy, however, surrounds just how harmful over-diagnosis is and whether information about this is communicated adequately to those considering participating in BreastScreen. So let’s hear from women.
We women – and men – say, yes of course we should be given adequate, reliable information about the risks and known harms to make sure any decision is fully informed. But just how great is that potential “harm”?
My early breast cancer was not caught by screening sadly (too young then), but by self-examination – hence at the symptomatic stage. Twenty years down the track I am living with metastatic cancer, pretty much as a chronic disease… read the full article.
