Earlier this month, the nationwide preventative care agency Public Health England (PHE) was racked with controversy after announcing that approximately 450,000 women did not receive invitations for a routine breast cancer screening due to an error in their automated computer system’s algorithm.
When addressing the public, Secretary of State for Health and Social Care Jeremy Hunt stated that investigators of a clinical trial that was using data from the Breast Cancer Screening Programme had identified an algorithm failure, dating back to 2009, that resulted in faulty calculations of the number of 68 to 71-year-old women who should have been notified that they were eligible for screenings at their local NHS hospital. Hunt warned that the PHE’s blunder could have shortened the lives of 135 to 270 women.
But following a review of the publicly available data, two Kings College London researchers believe the system glitch first arose in 2004, and the number of affected women is closer to 501,000 and includes those who fell into the wider age range of 55 to 70.
They did not re-estimate how many cases of cancer may have been missed, however.
“Data that might have alerted people to the lower than expected number of invitations being sent to women aged 70 were publicly available, but no one looked at them carefully enough,” Peter Sasieni and Shama Sheikh wrote in The Lancet. “Some of the fault lies in the way the data were presented, but it is also unclear whose responsibility it is to monitor such outcomes.”
The authors concluded by stating that they are looking forward to the results of the planned independent data review.
In response to their paper, PHE’s Director of Health Improvement John Newton told BBC: "This is a flawed analysis that fails to take into account some important facts, such as when the breast screening programme was rolled out to all 70-year-olds in England or when a [the clinical trial] was started.”
Regardless of the total number of women who did or did not receive invitations, many health experts argue that policies promoting universal mammograms – i.e. offering them to women with no specific risk factors other than age – should be discontinued altogether.
They cite multiple large-scale review studies that have found this screening methodology promotes dangerous misconceptions about breast cancer and leads to a concerning level of overdiagnosis. According to the British Medical Journal, approximately one-quarter of all diagnoses from routine mammograms are actually cases of overdiagnosis, which can lead to unnecessary painful, invasive biopsies and potentially deadly unneeded radiotherapy.
These outcomes obviously lie in stark contrast to the goal of helping women.