ABSTRACT
This first paper by Skrabanek questioned the credibility of screening for breast cancer, disputing the evidence for the size of benefit observed in the recently published HIP (New York) and Twocounties (Sweden) randomized trials and case-control (Holland) studies. He regarded breast cancer as an incurable disease, indicating that as it may take 8-9 years for a tumour to reach 1 cm in size, ‘early diagnosis’ by mammography is unlikely to affect the chance of cure but increases the time of anxiety and fear. Although mammography is the only method to detect breast cancer before it is palpable, false-positive tests result in unnecessary investigations and the risk of over-treatment, particularly of non-invasive cancer, while false negative tests, by giving false re-assurance, may eventually delay diagnosis. He was concerned that informed consent had not been the rule in screening studies and condemned breast self-examination as dishonest.
