Former NHS Breast Cancer Committee member: ‘Breast screening has not saved lives’
Professor who set up the first breast screening centre in the UK says that the introduction of screening increases the incidence of breast cancer by 50 per cent
Professor Michael Baum, School of Life and Medical Sciences (UCL)
Women who are invited to get screened for breast cancer are unaware that the harms of breast screening are greater than the benefits. This is the assumption made by Professor Michael Baum from the School of Life and Medical Sciences, University College London, at a lecture that marked Breast Cancer Awareness Month (October).
The NHS Cancer Screening Programme distributes leaflets to women aged over 50 in order to persuade them to schedule a screening. However, an article released by the British Medical Journal (BMJ) in early 2009 reported “what the leaflets don’t tell patients”. Prof Baum calls for attention from the Department of Health. “It is shameful and disgusting that women are denied the opportunity to learn the truth about screening”.
The New England Journal of Medicine has reported that one breast cancer death is avoided for every 2,500 women older than 50 screened for 10 years. Also a report from the the Cochrance Centre – a centre that focuses on medical evidence for treatments – estimates that for every breast cancer death avoided, 10 women are over-diagnosed. The UCL Professor reacts: “Against that, one thousand women will have at least one false alarm and five to 15 women will be treated unnecessarily for a disease that would never threat their lives.”
According to Professor of Medicine H. Gilbert Welch, over-diagnosis of cancer “occurs when the cancer regresses or when the cancer grows so slowly that the patient dies of other causes before it produces symptoms”. Because doctors don’t know which patients are over-diagnosed, unnecessary treatment and mastectomies often happen.
Screening theory says that catching an early, small tumours leads to a fall in the incidence of late cancer. Yet Prof Baum considers that early cancers do you mean tumours? are often inoffensive. “The really nasty fish, the sharks that will kill you slip through the net – and those are called cancers.”
The expert, whose mother died from breast cancer and whose sister also developed the disease, does not suggest that “we shut down screening”; instead, he recommends that there should be a “risk management campaign” making women aware that they are at a much higher risk of having cardiovascular disease than breast cancer.
When the NHS screening programme was established in 1998, it followed a report of 1987 that stated breast cancer mortality had been reduced by 25 per cent in the 1970s, when the trials were made. In the meantime, treatment has improved and the survival percentage rose to up to 85 per cent. Therefore, Prof Baum believes that improvements due to screening are becoming “narrower and narrower”.
Cancer: a man-made disease?
The excesses of modern life are often pointed out as one of the biggest influences on high rates of cancer worldwide. Yet these rates have only been reliably recorded in the UK since the 1970s – whereas back in the pre-industrial civilisations the life expectancy was too low to be compared to nowadays’ data.
That is the warning given by Dr Kat Arney from the Cancer Research UK on the Science Update Blog, after the media has claimed this week that cancer is a modern, man-made disease, according to a new study of ancient remains.
“This is not only scientifically incorrect, but misleading to the public and cancer patients”, says Dr Arney. Although our lifestyle and factors such as tobacco use and pollution do make us much more likely to develop cancer, comparing modern to ancient cancer rates is no correct evidence, especially given that age is the major risk factor for cancer.
In fact, many cancers are motivated by natural causes that have been around for a very long time. The ultraviolet radiation from the sun is the single biggest cause of skin cancer worldwide. Viruses motivate one in ten cancers in the UK, for instance the human papillomavirus as the cause for cervical cancers. And aflatoxin, a natural chemical that grows on peanuts and grains, is a significant cause of liver cancer in some African and Asian regions.
Also the New Scientist has analysed what is wrong with this study. Modern life does increase the risk of cancer, being smoking the cause for a quarter of all cancers. However, the concept of modern life stands for choices that people can change, and not an unavoidable scenario as the research implies.
The impact of this study is feared because blaming industrialisation for cancer might make people feel helpless about the situation. They could even think that exercising more or drinking less would not decrease the risk of developing cancer.
Moreover, will the people reading the Daily Mail generally be the same readers of the Science Update Blog or New Scientist?
This is just another example of how influent science journalism for the masses can be in people’s lifestyles and understanding of diseases.
You keep reading that if you eat gone-off food, you may get stomach cancer. If you drink too much, you may get liver cancer. If your mobile is next to your bed over night, you may get brain cancer. So the assumption of cancer as a modern disease is somehow correct – in the social sense of it.
‘Why everything you thought about COLDS is wrong!’
I wasn’t sneezing nor coughing anymore when I read another follow-up of Jennifer Ackerman’s new truths about colds: an adaptation written by Charlotte Dovey on yesterday’s Daily Mail.
Let me remind you that science writer Melinda Wenner Moyer had highlighted the difference between the strength of our immune system 1) when preventing a cold and 2) while fighting the cold infection once it has been established. This distinction is essential when judging our immune system performance, as some factors such as vitamin C may prevent a cold better than stopping it.
So imagining that our immune system has failed to prevent a specific cold infection (because your daily routine didn’t leave you time for healthier meals), let’s have a look at some of what Jennifer Ackerman found out that compromised our basic knowledge about colds:
1) You can’t catch a cold by kissing. Although this may surprise many people, a research at the University of Wisconsin Medical School has shown that the largest family of cold viruses rarely enters the body through the mouth. It appears to take as much as 8.000 times as much virus to cause infection from saliva than by other ways.
2) Staying indoors won’t protect you. Firstly, because your computer mouse and your desk are amongst the greatest sources of cold viruses. Secondly, because winter drives people indoors, where it becomes easier for viruses to jump from one person to another.
3) On the other hand, socializing won’t put you at risk. Did you know that people who socialize with many different people suffer fewer colds than those with smaller circles of friends? A wide social group contributes to a healthier lifestyle, which means that meeting a great variety of people does not increase your risk, as you may have thought.
4) Older people are not more vulnerable. Although they are risk-patients for many diseases, teenagers catch twice as many colds as people over 50 years old. The more colds you have been exposed to, the more antibodies you have developed to common cold viruses.
Scientists have discovered that our reception cells – those that “absorb” the viruses – as well as the amounts of inflammatory chemicals in our bodies differ from person to person. This explains why some people suffer more colds than normal. At the end of the day, it’s all about where we are coming from. Or, in Charlotte Dovey’s words: “blame your genes”.
Opening the Cold Season
I was actually sneezing and coughing when I bumped into “How not to fight colds: is it really that clear cut?“, where Melinda Wenner Moyer analyses an article by Jennifer Ackerman on The New York Times.
It is disappointing to be faced with the argument that these sneezing and coughing are caused not by a virus – as most people would believe since their childhood – but by our own body and its inflammatory response. It becomes even more disappointing when Jennifer Ackerman denies what our mothers have taught us: “the supplements, remedies and cereals that claim to strengthen immunity (and thereby protect you from colds) do no such thing.”
But isn’t it hard to believe that, after all, eating vegetables and drinking orange juice won’t prevent you from catching a cold? This appears to be Ackerman’s idea, but Melinda Moyer states this is no fair conclusion. Because: we need to distinguish two types of immunity.
While reading Moyer’s explanation, I compared the human body to an overcrowded open-air festival like the Love Parade in Duisburg, Germany, that killed 19 people earlier this year. The first active immunity is the security set installed around the festival location, which attempts to control the entrance of the massive crowd. They cannot allow too many people in at once – it would endanger their safety. This happens the same way our immune system tries to stave off infections.
But just as we have seen in Duisburg, no matter how strong the barrier is, intruders may end up breaking it. That is when the second type of immunity kicks in. Security guards spread around the festival venue and make use of their weapons for the sake of participants’ safety. However, they may become aggressive and increase panic among the crowd. The same happens in our body: the immune response produces inflammatory molecules that cause cold symptoms such as throat ache.
The tragedy in Duisburg could have been avoided if there was a better management of the security forces outside the venue.
In order words, please keep drinking orange juices and eating healthy salads and soups.
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