Doctors slam breast screening proposals


Health experts have accused the government of being blind to its own statistics by not including women aged 40 to 50 in its breast screening programme.

Government statistics show that outside the current screening age - 50 to 64 - breast cancer is more prevalent in women aged 40 to 50, not the 65 to 70 age group the government is proposing to include in the programme.

Breast cancer registrations for 2002 showed 426 women aged 40-50 had the disease, compared with 186 women in the 65-70 age group.

Breast surgeon Dr John Harman said the figures were shocking given the cancer had probably been present five to 10 years before diagnosis.

"In that time, it's had a chance to spread so if you leave it to pick up when they're 50, it's been sitting in the breast for 10 years," said Harman. "You can take all those 50 to 65-year-old figures and take them down five or 10 years and it means the peak incidence that cancer is occurring is probably about mid-40s."

Health Minister Annette King last week told the Sunday Star-Times she hoped to announce a plan to widen the screening age, which includes a free two-yearly mammogram, from 65 to 70.

But comments by King in parliament last week denying peak cancer rates in the 40 to 50 age group have angered a Tauranga family petitioning to get the screening age widened to 40-70 years.

"She (King) is wrong and we're really angry about this," said petitioner Tim Short. His wife Debbie, who had advanced breast cancer diagnosed at 44, said the system could not reveal the true peak diagnosis age unless free screening was available for those under 50.

A study in last month's New Zealand Medical Journal showed that women aged under 50 with breast cancer experienced a higher rate of more serious breast cancer (grade three) than those aged 50-plus.

Breast cancer kills more than 600 New Zealand women a year - a rate 28% higher than Australia, where mammograms are free from the age of 40.

It is estimated the cost of yearly screening for women aged 40-50 would be between $12 million and $15m.

Auckland Breast Unit head and surgical director Wayne Jones said with earlier detection, treatment costs would be lower.

"If you took it down to economics only, there's loss of income, cost of child care (for the women). The treatment of someone with advanced cancer is probably five times the cost (of low grade cancer)."

Surgeons point to overseas studies which show earlier screening leads to a significant drop in death rates.

A Swedish study published this year in British medical journal The Lancet showed the number of cases of breast cancer in women under 50 increased with the introduction of breast screening for the 40-50 age band, while the death rate dropped 48%.