Women in Britain need better information on breast screening to make an informed choice about whether to undergo mammography, according to a controversial report in the current issue of the British Medical Journal.
The report said women are being denied the proper information on which to make a decision whether to be screened or not.
"The question of whether the benefits of screening outweigh the harms is essentially a value judgement. The problem is that, up to now, this judgement has been made by paternalistic agents of the state rather than by women", the authors said.
However, the director of Breastcheck, the Republic's national breast-screening service, said the specific criticisms in the paper are not applicable here.
Acknowledging that deaths from breast cancer have dropped since screening began in Britain, the report questions whether this improvement is due to population screening or advances in cancer treatment.
The authors of the paper include Prof Michael Baum of the Department of Surgery at University College London, who helped set up the national screening programme in Britain in 1987, and Dr Hazel Thornton, a public-health specialist at the University of Leicester. She herself has had a ductal carcinoma in situ - where cells inside the milk ducts of the female breast have turned cancerous - which has an uncertain natural course and which the authors say "is little understood", leading to concerns about its management following a diagnosis during mammography.
The authors of the BMJ paper listed five common misconceptions about breast-screening: screening tests are meant for patients with known symptoms; screening reduces the incidence of breast cancer; early detection implies a reduced death rate; all breast cancers progress; and early detection is always beneficial.
However, Mr Tony O'Brien, the director of Breastcheck, said yesterday: "These concerns are not applicable in an Irish context. We provide women with balanced information and do not make unsubstantiated claims".
He agreed with the authors that there was a need for information outlining both the benefits and possible risks of screening for breast cancer.
However, Mr O'Brien referred to a percentage uptake rate in the low 70s as an indication that a significant percentage of women chose not to accept an invitation to screening from Breastcheck following receipt of information about the process.