Tonight I saw something which I think women should be aware of.
I'll state my position first... I basically agree with the findings. I am not a doctor. I am a woman.
I'll explain why I agree a bit further on.

The actual segment on 7.30 was to do with a Professor Goethke  and his findings, and the responses to it. These were reasonably presented,  and included pro and con views.
The findings basically presented the position that there is  significant  'over-servicing of women in Breast Cancer Screening', and that there are negative  possible outcomes to those women, who should be aware of the issue, so as to be properly informed of the steps they take in personal health care. .

Most specifically, but check it out for yourself if you're interested, that the mass Mammography screenings which around 54%of women now undertake regularly in Australia, are , at best ineffective in reducing harm from Breast Cancer, and at worst causes of unnecessary deaths in healthy women. 

That is a very quick summary, and not the full story .. BUT


the reason why I agree is from personal experience.

I have not had a mammogram for about 15 yrs,  and as a woman past her 55th year, some would consider that foolhardy.

I do have my reasons, but, umm given the history and some of the dispositions of some  posters on this Board,  I'll  wait tho to see the tenor of the responses, if any, before posting  further.

That they are both medical professionals would explain their reaction.

I do understand the gut-level instinct of the medical fraternity to deny what would seem to fly in the face of common practice.

I suggest they DO look at the findings..and then make an obviously qualified comment.

Would be appreciated.

at age 55 you can easily expect to live for another 30 years.
Good idea.

My mum has stopped them, she is in her 80's

oh yes, and it is 3 am, I am tired nd misread your posing

I've been aware of concerns about breast screening for many years now, the first Cochrane review came out over 10 years ago. I've wondered for years...when are they going to tell Australian women about these concerns? This topic has been hotly debated for many years overseas, but not much has been said here. Robin Bell from Monash Uni was the first to step forward and warn women, and that was only 2 or 3 years ago.

I'd urge all women to head over to the Nordic Cochrane Institute website and read their summary of the evidence for and against breast screening.
The NCI is an independent, not for profit, highly regarded medical research group, Peter Gotzsche is the head of the NCI. (I heard him speak at the Evidence Live Conference in Oxford last year)
Prof Gotzsche did not have a view on breast screening when he was asked by the Danish Govt to review the evidence for mammography, he was shocked by the findings and felt women should be told...so the summary was produced. It was first released over 10 years ago and has been translated into a lot of different languages.

I don't have breast screening, an informed decision. I think it's a personal decision, but women should at least be provided with all of the evidence and be left to make up their own minds. Forget targets, it should be about the individual and informed consent, and we should change the language used in women's cancer screening, no "must" or "should" or women who "avoid" screening, it's a choice, not a law.

Instead of real information we get celebrity endorsement, scare campaigns and a focus on the govt set target. The information provided to women is not balanced and complete, in my opinion. (to put it politely)
I find it quite insulting that they think I'll screen because Jo Hall thinks it's a good idea.

Men got risk information quickly for prostate screening and doctors were reminded to obtain informed consent, women are still waiting for the same ethical and respectful treatment.

The NCI say that about 50% of screen detected breast cancers are over-diagnosed and that any benefit of screening is wiped away by those who die from heart attacks and cancers after treatments.

There is also, an informative lecture on YouTube by Prof Michael Baum, the UK breast cancer surgeon who set up the first UK breast screening clinic. (and resigned when he realized they were not going to give women risk information) He has campaigned tirelessly to pressure the UK Govt to respect informed consent for women and release all of the evidence to women. See:
"Breast cancer screening:the inconvenient truth" by Prof Baum
There is also, a DVD called "The Promise" (breast screening) it's $6 but worth every cent.
I think Australian women need an explanation: why are we starting to hear about this now when its been a major concern for over 10 years now?

Be careful with our cervical screening program too, we have always screened too early and far too often, that provides no additional benefit to women, but greatly increases the risk of a false positives, excess biopsy or over-treatment.
We have huge referral rates, the lifetime risk of cc is 0.65%, the lifetime risk of referral under our program is 77%
The Finns have had since the 1960s a 7 pap test program, 5 yearly from 30 to 60, they have the lowest rates of cc in the world and refer FAR fewer women for biopsies etc. We "treat" more than 10 times the number of women.

Now the evidence has moved on and the Dutch program is one to watch, they'll scrap population pap testing, a burden for the vast majority of women who can never benefit (but can be harmed) and offer instead 5 HPV primary tests or HPV self testing at ages 30,35,40,50 and 60 and ONLY the roughly 5% who are HPV+ will be offered a 5 yearly pap test. Most women are HPV- and having unnecessary pap testing, biopsies etc.
The new Dutch program is likely to save more lives and just as importantly takes most women out of pap testing and harms way.
I have never taken part in the Australian program.

We're finally changing our program, but I fear excess will  remain, sounds like we'll move to 5 yearly HPV testing (no offer of self testing until you refuse the invasive test for 6 years or buy it through the manufacturer or through your GP) from age 25 to 72 or 74. This is over-screening, and it only takes basic research to find HPV testing is not recommended before age 30, about 40% of those aged under 30 will be HPV+, transient and harmless infections that will clear by age 30, by that age only about 5% are HPV+, these are the only women who should be offered a pap test.
Also, it sounds like we'll refer HPV+ women for colposcopy and biopsy when they should simply offer them a pap test.
I don't know why we struggle to follow and adopt the evidence and don't seem to respect informed consent for women.
I think both programs should be independently assessed by someone like the NCI and be properly monitored going forward to ensure they always put the evidence and informed consent first.

Eliz52 wrote on Feb 19^th, 2015 at 10:14am:



Thank you Eliz52 for your response.
I appreciate a reasoned and informed reply. You have added to my information.
  I will now consider the possible over-servicing and treatment for CC, 'cos that is the only program I have participated in. They have been all negative and I do wonder at the benefit.. At 55+ I doubt they have any benefit.. 
Thank you

Emma wrote on Feb 18^th, 2015 at 8:13pm:


I think there might be a little over servicing also, but believe it's set up that way to encourage more women to have checkups. The conscientious women who do get a screening every couple of years probably get over serviced to make up the numbers. The problem is if they cut back on it, it's quite possible that the incidence of cancer will increase. My mother had breast cancer and that's why I'm fairly diligent about regular screening and appreciate the easy availability of it.

Emma wrote on Feb 22^nd, 2015 at 2:38am:


Perhaps I should have said deaths will increase if the availability of services are reduced because it won't be so easily accessible to women.

Mammograms and ultrasounds can pick up small amounts of fibrous tissue that females don't know they have. Often this will lead to a biopsy where they can pick up a change in cells.

If they start reducing services - then there will be longer waits for a mammogram.

Obviously having regular mammograms is a choice, but not having one for 15 years is foolish.

Emma wrote on Feb 23^rd, 2015 at 1:30am:


I go by advice from the experts Emma. If you choose never to be screened - then that's your decision. Even those without a family history aren't immune.

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Wallow in ignorance - that's your prerogative. It is not compulsory obviously - just recommended.

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Again - ignore the recommendation of experts. You seem to believe your opinion is the only one which matters and that's fine, but don't infer women are stupid because they choose to have regular screening.

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Only because you don't bother with it. Millions of women do believe it is effective and necessary for peace of mind and early intervention.

You are in a susceptible age group and there are other contributing factors such as not having children or breast feeding - so the risks are there.

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