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DCIS, overtreatment and professionalism

There’s an article in the Guardian describing the US treatment of a woman who had DCIS diagnosed at screening, in one breast. She went on to have bilateral mastectomy, with flap reconstruction, an autologous blood transfusion, and a stay in ITU. The author writes ” It is so confusing. What was that all about? Cancer? […]

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Myrios and their adverts on the tube

Myrios are running adverts on the London tube. This company offers blood testing for various conditions. I am troubled by the evidence and practice of their testing.   “We always advise you visit your local pharmacist who will be able to recommend the right test based on your health concerns.” They also say, in their […]

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Review of breast cancer screening evidence

Professor Susan Bewley challenged Prof Mike Richards on the evidence for her invite to breast screening, in the BMJ. He responded by saying a review was already underway, but it sounds like a weird review. He says that “An independent review of the research evidence (randomised controlled studies and observational studies) is being undertaken, led […]

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Breast screening challenged (again)

Surely we shall see some progress on proper information about breast screening soon? From this week’s BMJ: basically, improvements in breast cancer treatment, not access to breast screening, can explain improvements in mortality from the disease. This is important information for women who are deciding whether or not to have breast screening. As I’ve said […]

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Ovarian cancer screening is ineffective and harmful

Important paper in JAMA: ovarian cancer screening using transvaginal ultrasound and serum Ca-125 testing does not reduce mortality from ovarian cancer. Worse, there “Diagnostic evaluation following a false-positive screening test result was associated with complications”. The harms of this ineffective intervention: “Of 3285 women with false-positive results, 1080 underwent surgery (32.9% for oophorectomy) as part […]

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NICE guidance on ovarian cancer diagnosis

NICE, in new guidance, are telling GPs to perform CA-125 tumour markers in patients with possible ovarian cancer. They say “Asking the right question – first tests Measure serum CA125 in primary care in women with symptoms that suggest ovarian cancer (see section 2.1 on page 43). If serum CA125 is 35 IU/ml or greater, arrange […]

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