Screening by high-quality programs successfully detects cancers at an earlier stage
In 2002, the 10th anniversary of Australia's national program of mammographic screening for breast cancer, it is perhaps timely to reflect and review. The need for reassessment is highlighted by the recent furore in the breast-screening world1-4 precipitated by a Cochrane review by Olsen and Gøtzsche.1 In this issue of the Journal, the article by Barratt et al5 (page 266) also encourages us to review breast-screening policies — in this case for women 70 years and over who are no longer in the target group for free mammographic screening (50–69 years).
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- 1. Olsen O, Gøtzsche PC. Screening for breast cancer with mammography. In: Cochrane Library, Issue 4. Oxford: Update Software, October 2001.
- 2. Olsen O, Gøtzsche PC. Cochrane review on screening for breast cancer with mammography. Lancet 2001; 358: 1340-1342.
- 3. Horton R. Screening mammography — an overview revisited. Lancet 2001; 358: 1284-1285.
- 4. Screening for breast cancer with mammography [letters to the editor]. Lancet 2001; 358: 2164-2168
- 5. Barratt A, Irwig L, Glasziou P, et al. Benefits, harms and costs of screening mammography in women 70 years and over: a systematic review. Med J Aust 2002; 176: 266-271. <eMJA full text>
- 6. BreastScreen Victoria 1999 Annual Statistical Report. Melbourne: BreastScreen Victoria, 2001.
- 7. Gøtzsche PC, Olsen O. Is screening for breast cancer with mammography justifiable? Lancet 2000; 355: 129-134.
- 8. Simes J, Wilcken N, Brunswick C, et al. Screening mammography — setting the record straight. Lancet 2002; 359: 439-440.
- 9. Giles GG. Canstat : cancer in Victoria 1999. Melbourne: Anti-Cancer Council of Victoria, August 2001.
- 10. Breast cancer in Australian women 1982–1996. Australian Institute of Health and Welfare; Australasian Association of Cancer Registries. Canberra: NHMRC National Breast Cancer Centre, 1999.
- 11. Breast cancer size and nodal status. Cancer monitoring No 2. Canberra National Breast Cancer Centre; Australasian Association of Cancer Registries; BreastScreen Australia; Department of Health and Aged Care; Australian Institute of Health and Welfare, October 2001.
Alan Rodger has been a member of the Cochrane Breast Cancer Editorial Group since June 2001. He is Chair of BreastScreen Victoria.