Friday, August 2, 2013

It is reasonable for me not to attend breast cancer screening with mammography

(Image: BreastScreen New South Wales bumpf)

Dear BreastScreen New South Wales & NSW Electoral Roll,

Ever since I have turned 50, I have been bombarded (thanks a lot, NSW Electoral Roll, for allowing access to my data!) with advice to get myself down to your nearest mobile mammogram van for screening purposes - and resolutely I have refused.

No, no, no, and I've been saying this for over 3 years now.

Of course as is customary in Australia, my wishes have been completely ignored due to an expectation that I will comply with your jolly summons. However as is customary with me, I invoke my right to express my informed refusal and therefore I continue to decline your services.

I have both ignored you and written to you in an attempt to unsubscribe from your mailing list but to no avail. I am still getting your spam - endless reminders and invitations, even missives of concern inquiring whether I didn't receive your last one or perhaps overlooked your first letter way back in the day when I toasted my arrival into my 6th decade!

No I haven't been 'overlooking' and I don't need 'reminding' - I just don't want your mail or mammogram period

Moreover I feel quite reassured that my current position of refusal is informed when I read Dr Peter G√łtzsche's reflections especially where he says, "it is getting more and more difficult to argue that it is reasonable to attend for breast screening."

There we have it - so please please please...desist telling me that it only takes a short time and may save my life, I TRULY DON'T WANT TO BE COMMUNICATED WITH...OR SCREENED.

Kind regards,
Sue Abbott


  1. Sue, I've also, declined breast screening, an informed decision, and over 30 years ago I also, declined cervical screening. Shock, horror, a woman declining elective screening!

    There is a concerning attitude in women's cancer screening in this country, we get no real information, we get spin, threats, scary stories etc. and we're expected to file in like ignorant sheep. There is zero respect for informed consent, our legal right, the emphasis is on coverage, protecting the programs. (not women)

    I wrote to Breast Screen and informed them I would not be attending for screening. I explained why fairly briefly. I haven't heard from them since. (5 years ago now)

    Beware of the cervical screening program here as well, it is not evidence based, it's excessive; we do everything to maximize risk for no additional benefit. We screen far too early, far too often and for far too long and so we have, as a result, lots of false positives and huge (and hidden) excess biopsy/over-treatment rates.

    This cancer is rare, always was and it was in natural decline before testing even began, the lifetime risk is 0.65%...the lifetime risk of referral with our program is 77%
    We "treat" more than ten times the number of women than a country like Finland.

    Finland have (since the 1960s) offered 6-7 pap tests, 5 yearly from 30 to 60, and they have the lowest rates of cc in the world and refer FAR fewer women for potentially harmful biopsies etc. (damage to the cervix can lead to premature babies, c-sections, cervical cerclage, miscarriages etc.)

    The Dutch had the same program as the Finns, but the Health Council of the Netherlands has recommended scrapping population pap testing. They'll offer instead 5 HPV primary tests at ages 30,35,40,50 and 60 and ONLY the roughly 5% who are HPV+ and at risk will be offered a 5 yearly pap test. (until they clear the virus)

    This will save more lives and take most women out of pap testing and harms way. The Dutch are already using the Delphi Screener, a Dutch-invented self-test HPV device. (Aussie women can order it from Delphi Bioscience Singapore)
    Those women who test HPV- who are no longer sexually active or confidently monogamous might choose to stop all further testing.

    Aussie women are still being told they "need" 26 (or even more pap tests), this is bad medical advice. Our GPs receive target payments for pap testing, a conflict of interest never disclosed to women. Some doctors still tell women they must have pap tests if they take the Pill...untrue. The Pill has nothing to do with cancer screening.

    I believe vested and political interests control these programs, millions is made from over-screening and over-treatment, and women's health is considered a vote winner. Add high emotion and misinformation and you have a toxic mix, not good for our health.

    The level of awareness in this country is also, a worry, most women have no clue and submit to this testing, few would understand the risks and actual benefits. Men are not treated in this way.

    I won't go through the risks and benefits of breast screening, you're clearly an informed woman, sadly, we're thin on the ground in this country. These discussions have been going on for a long time in the UK and elsewhere. It makes you wonder why we're only just hearing about these issues in this country. (thanks to two brave doctors who decided to warn women, 2 in the whole country!) and it's still near silence with cervical screening.

    Our cervical screening program is now finally under review...but I fear excess will be protected, it sounds like we'll move to 3 yearly pap testing from 25 to 70. We'll stay with shocking over-screening and the outdated pap test, a cruel burden for the vast majority of women who cannot benefit, but are exposed to risk with this testing. Who are we protecting in this country, the programs or women?

    If Breast Screen keep hassling you, it might be worth paying for a short letter from a solicitor, no one has the right to harass us.


  2. PS I was lucky enough to hear Peter Gotzsche from the Nordic Cochrane Institute speak at the Evidence Live conference in March this year. His opening sentence: breast screening is harmful and should be stopped. (See: Mammography Screening: Truth, Lies and Controversy by Peter C. Gotzsche)

    It was interesting to speak to so many female doctors who've declined breast screening. Some felt guilty that they had access to information not given to their patients and were better able to refuse screening. So many women are intimidated by doctors and the medical setting and with no real information provided, may find it hard to fight off medical/program pressure. Just sending letters constantly gets to some women who give in and screen, just to stop the letters.
    Dr Margaret McCartney also, spoke at the conference, a Scottish GP, who wrote, "Patient Paradox". She publicly admitted she does not have pap testing and will refuse breast screening when she turns 50. You might find her blog interesting.
    Professor Michael Baum is another amazing doctor; there is an interesting lecture online, "Breast Cancer Screening: The Inconvenient Truth", he's a UK breast cancer surgeon and has fought tirelessly for decades to warn women and change the system. He helped set up breast screening in the UK many years ago, but then became concerned about the screening process and the lack of respect for informed consent.
    Let me know if you'd like some references. I post at

    (Professor Baum's lecture) (Dr McCartney)

    Best Wishes

  4. Hi Elizabeth,

    Thank you so much for your informed comments - it is so heartening to read thoughts from a like-minded soul - I'm afraid most of my buddies and family all subscribe to the 'if it saves one life' view which personally I think is a load of is rubbish, and a ridiculous argument for public health policy.

    I too have eschewed the hysteria re cervical screening and have only had one in the last 23 years which was one too many given that I am 'confidently monogamous' (great expression) and have been for decades!!!

    Thanks for taking the time to comment so sagely, and three cheers to the brave medicos who swim against the Big Money hysterical current, and who doggedly keep us informed with evidence - I love evidence.

    Kind regards,