Mammography Screening

Foreword by Iona Heath Foreword by Iona Heath Foreword by Fran Visco Acknowledgements Introduction What it really means to be 'controversial' Our collaboration with the media Important issues in cancer screening What it means 'to have cancer' Overdiagnosis and overtreatment Erroneous diagnoses and carcinoma in situ Basic issues in cancer epidemiology Randomised trials, observational studies and a little statistics Why screening leads to misleading survival statistics Why 10--year survival is also misleading Does screening work in Sweden? Stonewalling the Cochrane report on screening The Danish National Board of Health interferes with our report Troubling results in the Lancet The Canadian trials Media storm Email from researchers Our collaboration with the trialists Ten letters to the editor Creative manipulations in Sweden Peter Dean, a remarkable character Bad manners also in Norway Continued troubles in Denmark Harms dismissed by the Cochrane Breast Cancer Group The process with the Cochrane review Of mites and men Confusion over who is in charge The Lancet publishes the harms of screening Vitriolic mass email from Peter Dean Beating about the bush in the United Kingdom Condemnations in Sweden Contempt of science in Denmark and Norway Delayed media storm in the United States after our 2001 reviews Miettinen and Henschke's cherry--picking in the Lancet Additional reactions in the United States The Danish National Board of Health circles the wagons US and Swedish 2002 meta--analyses US Preventive Services Task Force's meta--analysis Nystrom's updated Swedish meta--analysis Scientific debates in the United States Peter Dean is wrong again Multiple errors in the International Journal of Epidemiology Publication of entire Cochrane review obstructed for 5 years Cochrane editors stonewall our Cochrane review Lessons for the future Welcome results in France Editorial misconduct in the European Journal of Cancer Editorial misconduct Threats, intimidation and falsehoods Debates in the Scientist and the Cancer Letter Tabar's 'beyond reason' studies Criticism of our work in the Journal of Surgical Oncology Other observational studies of breast cancer mortality The United States and the United Kingdom Denmark, Lynge's 2005 study Denmark, our 2010 study Overdiagnosis and overtreatment Cancers that regress spontaneously The 1986 UK Forrest report Overdiagnosis in the randomised trials Systematic review of overdiagnosis in observational studies Observational studies from Denmark and New South Wales The doubt industry Duffy's studies on overdiagnosis Lynge's studies on overdiagnosis Carcinoma in situ and the increase in mastectomies Ad hominem attacks: a measure of desperation? UK statistician publishes in Danish Inappropriate name--dropping Further ad hominem arguments Lynge's unholy mixture of politics and science Ad hominem attacks ad infinitum US recommendations for women aged 40-49 years What have women been told? Website information on screening Invitations to screening A scandalous revision of the Danish screening leaflet Our screening leaflet Breast screening: the facts, or maybe not American Cancer Society Information from other cancer societies Getting funding or not getting funding What do women believe? Extraordinary exaggerations What is the ratio between benefits and harms? Duffy's 'funny' numbers Exaggerating 25--fold The exaggerations finally backfire The ultimate exaggeration Tabar threatens the BMJ with litigation Falsehoods and perceived censorship in Sweden Celebrating 20 years of breast screening in the United Kingdom Can screening work? Plausible effect based on tumour sizes in the trials Lead time Plausible effect based on tumour stages in the trials No decrease in advanced cancers Where is screening at today? Problems with reading mammograms False promises Important information is being ignored Beliefs warp evidence at conferences Does breast screening make women live longer? Where next? Is screening a religion? A press release from Radiology that wasn't Has all my struggle achieved anything? Why has so much evidence about screening been distorted? Time to stop breast cancer screening Appendix 1: Tabar's explanations in the Cancer Letter and our replies Appendix 2: Our 2008 mam-mography screening leaflet Appendix 3: The press release Radiology withdrew at the last minute Index