AccScience Publishing / TD / Volume 1 / Issue 2 / DOI: 10.36922/td.v1i2.228
Cite this article
Journal Browser
Volume | Year
News and Announcements
View All

Benefits and harms of screening: Overdiagnosis and anticipatory medicine – A secondary publication

Antonio Zarazaga Monzon1* Ángeles Franco-López2,3 Jesús M. Culebras4
Show Less
1 Department of Surgery, Autonomous University of Madrid, 28049 Madrid, Spain
2 Radiology Services, Vinalopó and Torrevieja Hospitals, Spain
3 University by ANECA, Alicante, Spain
4 Royal Academy of Medicine of Valladolid and IBIOMED, University of León, León, Spain
Tumor Discovery 2022, 1(2), 228
Published: 17 November 2022
© 2022 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

The treatment of breast cancer has changed markedly since the publication of works that recommend screening for the early diagnosis of breast cancer. Retrospective reevaluations have revealed errors in screening; moreover, advances in oncological therapy and a better understanding of the disease have raised doubts toward the efficacy of these procedures, which might also cause side effects alongside the risk of overdiagnosis and overtreatment. On the other hand, the lack of information or even misinformation might cause confusion among the potential beneficiaries of these procedures, particularly the patients. These procedures are constantly being recommended by institutions, but the possible risks accompanied by these procedures are often not explained. It is easy to promote mammography screening if the majority believe that it reduces the risk of breast cancer and saves lives. Unfortunately, this is not the case. Many critics of screening are now demanding clear and precise explanations of the procedure and emphasizing on the importance of physical examination. Women must make informed decisions before screening by discussing their own risk profile, the possible benefits, and the eventual risks and harms of mammogram with their physicians. Women should be classified into two groups: those who would gain potential benefits from the procedure and those whose risks outweigh the benefits. A screening program that clearly does not offer more benefits than risks cannot be implemented by public heath institutions. Providing complete and unbiased information, promoting appropriate care, as well as preventing overdiagnosis and overtreatment would be the best option. 

Breast cancer
Anticipatory medicine
Refer to primary version.

Sackett DL, Holland WW. 1975, Controversy in the detection of disease. Lancet, 2(7930): 357–359.


Sackett DL. 2002, The arrogance of preventive medicine. CMAJ, 167(4): 363–364.


Nyström L, Rutqvist LE, Wall S, et al. 1993, Breast cancer screening with mammography: Overview of Swedish randomised trials. Lancet, 341(8851): 973–978.


Gøtzsche PC, Nielsen M. 2006, Screening for breast cancer with mammography. Cochrane Database Syst Rev, 2006(4): CD001877.


Bleyer A, Welch G. 2012, Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med, 367(21): 1998–2005.


National Breast Cancer Coalition. 2011, Mammography for Breast Cancer Screening: Harm/Benefit Analysis. Washington, D.C: National Breast Cancer Coalition.


Gøtzsche PC, Jørgensen KJ. 2013, Screening for breast cancer with mammography. Cochrane Database Syst Rev, 6: CD001877.


Gøtzsche PC. 2012, Mammography Screening: Truth, Lies and Controversy. London: Radcliffe Publishing.


Jørgensen KJ, Keen JD, Gøtzsche PC. 2011, Is mammographic screening justifiable considering its substantial overdiagnosis rate and minor effect on mortality? Radiology, 260(3): 621–626.


Biller-Andorno N, Jüni P. 2014, Abolishing mammography screening programs? A view from the Swiss Medical Board. N Engl J Med, 370(21): 1965–1967.


Gøtzsche PC, Harting OJ, Nielsen M, et al. 2012, La mamografía como método de cribado para detectar el cáncer de mama. Centro Nórdico Cochrane. Available from:


Prasad V, Lenzer J, Newman DH. 2016, Why cancer screening has never been shown to “save lives”-and what we can do about it. BMJ, 352: h6080.


Gigerenzer G. 2016, Full disclosure about cancer screening. BMJ, 352: h6967.

Conflict of interest
Refer to primary version.
Back to top
Tumor Discovery, Electronic ISSN: 2810-9775 Published by AccScience Publishing