Benefits still outweigh risks

1 January 0001

In Australia, researchers say from the research that has been done, estimates vary so widely that it's difficult to interpret the data.

Winsome Denyer reports.

WINSOME DENYER: The advice across Australia is resounding:

(Except from breast screen ad)

EVONNE GOOLAGONG-CAWLEY: Early detection could save your life and a breast screen is the best way to find it early so please have one every two years.

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WINSOME DENYER: Former tennis player Evonne Goolagong-Cawley is the latest celebrity ambassador to lend her support to a breast screening campaign. And while the evidence that screening saves lives remains overwhelming, a review in the UK has found that the risk of over-diagnosis is substantial.

The review panel found that while screening in the UK prevented around 1300 breast cancer deaths each year, it also led to 4,000 over-diagnoses.

Cancer patient Miriam Pryke told the BBC she felt she wasn't given the full picture of the risks.

MIRIAM PRYKE: Cancer treatment is not a walk in the park, you don't want that. It's a tragedy when it's necessary, but it's appalling to have it when you don't need it.

WINSOME DENYER: But Vicki Pridmore from Breast Screen Victoria warns women shouldn't be deterred from having regular mammograms.

VICKI PRIDMORE: The problem is we've still got that big black hole where we can't say to a woman, 'Look, we've diagnosed a cancer, but we can tell you that this cancer can just lay there and it will not harm you in your lifetime. You will die of something else.'

I mean, nobody wants to go in there and subject somebody to a diagnosis of cancer, and both the psychological and physical consequences of that.

WINSOME DENYER: While Health experts in the UK say women need more information to help make an informed decision about their treatment, Vicki Pridmore believes in Australia that is already happening.

VICKI PRIDMORE: Informed consent is fabulous and good practice, but even then we know that we're going to be raising anxiety in some women about which way they should go.

But I suppose my job and anybody else who's in a similar role is to lay out for women clearly: this is the research we have, these are the harms, these are the benefits, but you must make an individual choice, because all of the research is at a statistical level, but it's you and I and every other woman who's having to make that choice.

WINSOME DENYER: Maxine Morand from the Breast Cancer Network of Australia says women have to weigh up the risk of being given treatment they don't need with the chance of detecting cancer early enough to save their life.

MAXINE MORAND: I'd hope that this sort of research doesn't make women feel that they shouldn't go and have a screening mammogram. Screening definitely saves lives, early detection is very important.

My cancer was picked up on a screening mammogram and I'm very pleased that it was picked up early and it had a very significant impact on the type of treatment I had to have and on my prognosis.

WINSOME DENYER: Even after treatment, it's impossible to know how that prognosis might change.

MAXINE MORAND: Many women are on drugs for many, many years after the initial treatment - I'm on a drug for the next five years, and no one can tell you necessarily that it's working. There's no real way of knowing.

WINSOME DENYER: Vicki Pridmore says the only way to reduce over-diagnosis is through further research.

VICKI PRIDMORE: Right now in Australia we screen women every two years, that's what the program says, between 50 and 69, every two years.

Now the ideal would be able to say: 50 per cent of those women need never come to us, or 20 per cent of them need never come to us. Ten per cent you should come every year, and the rest of you should keep up on your two-year cycle. But we're just not at that spot.

MARK COLVIN: Vicki Pridmore from Breast Screening Victoria speaking to Winsome Denyer.

Listen to the interview on the ABC PM website.

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