An analysis of the effectiveness of population-based screening for breast cancer.

Breast cancer is the leading cause of death due to cancer in women, with statistics from the USA showing that one in eight women will develop the disease.1 Studies in the UK show that 90% of women diagnosed in the early stages survive the disease, while this figure is only 15% if diagnosed at a later stage illustrating the importance of an effective screening programme to reduce mortality.2 In the following essay I will review various randomised control studies and cohort studies in order to establish how nationwide screening programmes best reduce mortality, looking at the targeted sector of the population and the methods in practice. I will also address how the public health sector could improve on early detection and possible policies that could be implemented. Additionally I will review whether current methods of screening for breast cancer in more economically developed countries can also be implemented in less developed countries. With 1.38 million women having been diagnosed with breast cancer in 2008 I feel this issue is of relevance as chronic diseases such as this one show no signs of eradication in the near future and late stage treatment is both invasive for the individual and damaging to the economy.2

Before delving into the effectiveness of screening programmes the methods used to diagnose breast cancer at an early stage should be mentioned. Screening for breast cancer is usually a mammogram once a year once a woman is over 40, though women who are aware that the BRCA1 or BRCA2 gene is present in their family are recommended to consult a doctor at an earlier age to discuss how often they should have mammograms and when to begin .4 A mammogram involves two x-rays of each breast, these images are then reviewed by a specialist for any abnormalities. Another alternative