Early detection of cancer is cited by many as our best route for tackling this disease, but a recent retrospective trend analysis published in the British Medical Journal indicates that mammography has not significantly contributed to reduced death rates from breast cancer.

Philippe Autier, Research Director of the International Prevention Research Institute in Lyon, France, and colleagues examined data from the World Health Organization mortality database for three pairs of countries with comparable socioeconomic and health care systems in which one country introduced breast cancer screening 10–15 years after its comparator between 1989 and 2006. The death rates dropped by statistically similar amounts, indicating, according to Autier, that “mammography is not doing the job.” (Bloomberg, 28 Jul 2011). These findings could be seen to justify the change in guidelines in the United States 2 years ago to scale back recommendations on breast screening and also adds credence to the argument that many early, premalignant breast lesions that are detected by mammography result in unnecessary treatment. Dr Karsten Juhl Jørgensen of the Nordic Cochrane Centre in Denmark who published similar findings last year stated that “we are turning thousands of healthy women into breast cancer patients”. (The Telegraph, 29 Jul 2011).

However, many of the responses to this paper have been to urge women to continue to attend breast screening. “We know that early detection of breast cancer may lead to simpler and more effective outcomes”, said Rachel Rawson, a clinical nurse specialist at Breast Cancer Care. (WebMD, 29 Jul 2011). These data are also contradicted by a publication last month showing that regular mammograms prevent deaths from breast cancer and the number of lives saved increases over time.