NHS screening advice ‘must improve’


The NHS needs to get better at highlighting the dangers of screening for diseases such as cancer, say MPs.

Screening picks up diseases early to improve the odds of survival or improve quality of life.

But the practice also leads to “overdiagnosis” and people having treatment for conditions which would never have caused harm.

The Science and Technology Committee accused the NHS of “poor communication” on the issue.

Breast-cancer screening became hugely controversial in 2012. An independent review was set up to settle a fierce debate about whether the measure did more harm than good.

It showed that for every life saved, three women had treatment for a cancer that would never have proved fatal.

As a result the leaflets given to women offered a mammogram included more information to give them an “informed choice”.

‘Unnecessary treatment’

However, the Science and Technology Committee argues the lessons have not been learned by those overseeing other screening programmes.

Andrew Miller, the committee chairman, said: “While screening can increase the likelihood of curing, preventing or delaying the progression of disease for some patients, for others it may lead to false results, misdiagnosis and unnecessary treatment.

“More needs to be done to ensure that both the benefits and risks are clearly, and even-handedly, communicated so that people can make an informed choice about whether screening is right for them.”

Conditions screened for include:

  • Abdominal aortic aneurysm
  • Diabetic retinopathy
  • Breast cancer
  • Cervical cancer
  • Bowel cancer

There are also newborn screening programmes, including hearing checks, as well as Down’s syndrome and foetal anomaly screens during pregnancy.

Breast-cancer screening guidelines were changed to ensure patients had an informed choice

Mr Miller continued: “Producing accurate, concise and accessible public information on screening will always be challenging, but the UK National Screening Committee must ensure there is standard process across the NHS for achieving this and facilitating informed choice.”

There are hopes that screening could be extended to other diseases such as ovarian cancer and eventually prostate cancer.

However, the committee said the barriers to new screening programmes “should remain high” due to the delicate balance of risk and benefits.

‘Vitally important’

Prof Kevin Fenton,, director of health and wellbeing at Public Health England, which oversees the NHS screening programmes. said: “We welcome the findings of the Science and Technology Committee’s report, which has identified a number of recommendations.

“We will now consider these recommendations in full.”

The British Medical Association’s Dr Richard Vautrey said: “Many GPs will share the Science and Technology Committee’s concerns about health screening. As the BMA has repeatedly warned, it is vitally important that people being invited for screening fully understand the pros and cons of the procedure.

“Patients must also be aware that there is a risk that false positive results could lead to unnecessary and potentially harmful further investigations.”

Cancer Research UK was involved in the independent review of breast-cancer screening.

Jessica Kirby, from the charity, said: “It’s vitally important that all screening programmes are based on the best possible evidence so people can be confident that screening is only offered where the benefits outweigh the harms.

“The report highlights the importance of ensuring people get the best possible information so they can make the decisions that are right for them.”