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Breast screening error: disaster or blessing in disguise?

The NHS computer error that has resulted in some 450,000 women aged around 70 not having received an appointment for a final breast screen is obviously, and understandably, deeply worrying for the women concerned. Predictably, the media have headlined the estimate that up to 270 of them may have developed cancers that are more advanced and difficult to treat than they would have been if diagnosed earlier. But this depends on a number of assumptions. Leaving aside the fact that this is the upper limit of an estimated 135-270 range (compare the "up to" speeds quoted by ISPs - how many customers achieve them?), the situation, as usual, is more complicated than the headlines imply.

New Scientlst has a good discussion of the question (Why breast screening error stories are getting death stats wrong). This article makes the important point that, for some women, the failure to notify them may have done them a favour. The current NHS estimate is that, for every 200 women in the 50-70 age range screened, one will be spared an early death but three will have unnecessary treatment for cancers that would not have been a problem in their lifetime.


... it means that up to 800 women may have been saved from harm by not sending them their final screening appointment letter, as they avoided possible reduction in their life expectancy through unnecessary treatment.


The New Scientist article makes the important point that the women who received unnecessary treatment would never know this and would presumably be forever grateful, believing that their lives had been saved by the 'harrowing treatment process'. So this is an 'invisible' harm that is difficult to quantify.

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