Het nut van bevolkingsonderzoek naar borstkanker; een advies van de Gezondheidsraad

- A recent Cochrane review does not nullify the evidence supporting the practice of mammographic population screening for breast cancer for women aged 50 years and over. Thus concludes the Health Council of the Netherlands in an advisory report to the Dutch Government. A central feature of the Cochrane review is the conclusion that breast-cancer mortality is an unreliable outcome that is biased in favour of screening. The Health Council finds this conclusion too extreme and does not support the view that breast-cancer mortality must be replaced by overall mortality as an outcome. The Health Council does agree with the view that the use of disease-specific mortality as the only endpoint renders cancer-screening trials subject to bias. Therefore, careful attention should be paid to total cancer mortality, other important causes of death, and overall mortality.