[Population-based breast cancer screening is not worthwhile. Screening has little effect on mortality]. / Bevolkingsonderzoek naar borstkanker loont niet. Screening heeft nauwelijks invloed op sterfte.

ABSTRACT

Comparison of breast cancer mortality between pairs of similar countries (Sweden and Norway, Northern Ireland and the Irish Republic, the Netherlands and Belgium or Flanders), each of which had implemented its population-wide breast cancer screening programme at a different point in time, demonstrated little effect of screening on mortality. In the Netherlands, a well-organised population-wide screening programme was started in the early nineties, ten years before such a programme was introduced in Flanders. We used the 1989-1992 period as a baseline and compared breast cancer mortality in the Netherlands with that in Flanders during the 2005-2008 period. The added value of organised screening was low 11% in the target age group of 55-79 years, or 180 prevented breast-cancer deaths annually. A total of 5000 screening mammograms were needed to prevent one death from breast cancer. Breast cancer screening is not a public health priority. Impartial and transparent information on the disadvantages and benefits of breast cancer screening is urgently needed.