Technology Holds the Key to Modernising Breast Cancer Screening; Jack Kaye CEO
London, May 6, 2012 AEST (ABN Newswire) - Breast cancer has become a major healthcare issue in the United Kingdom over the past two decades. Since the 1980s, breast cancer has received increasing attention throughout the world, due to the startling rise of the disease. The annual Breast Cancer Awareness month in October, which sees millions of pounds raised for research and charity, is testament to this.
Statistics gathered over the past two decades suggest that breast cancer is caused by environmental factors. North European women have a relatively high probability of developing the disease, along with North Americans and Australians, compared to those from the Mediterranean or the Far East. For example, a Japanese woman born and raised in her homeland will have a very low chance of developing the disease.
However, if she was to live in the UK for five years or more, she will have the same probability of developing the disease as a local. Whilst a scientific explanation remains absent, the reality is that breast cancer poses a greater threat to women in the UK than in other areas of the world.
This year in particular has seen breast cancer fill the news headlines - new research, criticism of the screening process and incidents such as the PIP breast implant scandal. However, arguably the most important news came in October 2011 with the announcement of an independent review into the NHS mammogram breast screening programme. The review, led by Professor Sir Mike Richards, national cancer director at the Department of Health, aims to update the current programme with more developed medical devices.
Nevertheless, mammogram screening saves lives because it allows breast cancers to be diagnosed and, if treated early, lowers mortality rates. That is an established fact, proven by decades of data from the US, Europe and here in the UK. Statistics show that in 1982, the year that the NHS started its breast screening program, there were over 18,000 related fatalities - an increasing trend from the 1970s. Since then, mortality from breast cancer has declined steadily to about 12,500 a year and stabilised at that level. The UK's mortality rate remains above many European neighbours such as Germany and Sweden, suggesting improvement is achievable.
However, at present there are a number of broad issues with the current UK screening programme that need to be addressed:
Age footprint
A woman's risk of developing breast cancer dramatically increases from the age of 42. The current UK screening programme only targets women from the age of 50, although this will soon be reduced to 47 - a clear admission of the fact that screeing at 50 or over is often far too late to prevent breast cancer becoming fatal. Unfortunately, 47 will be too late for many women as well as breast cancer can effect far younger women. Consequently, screening should be made available for all women over the age of 18 as breast cancer is known to develop this early.
Incidence
The frequency of screening is under question. The medical evidence is clear - survival rates for some breast cancers are much better with higher frequency screening. Official advice in the US is for mammograms to be performed at least once every 2 years, while some US organisations advocate annual screening.
Of course it is easy for a government to advise more frequent screening when the Government does not pay for it. The US medical industry is still mainly funded by private insurance, although Medicaid (tax funded medical insurance) is expanding under Obama's reforms.
But even those organisations associated with Medicaid recommend bi-annual screening. Screening in the UK remains once every three years. Reducing this period would lower mortality rates for breast cancers.
Precision
Recent research in the UK has questioned the efficacy of mammograms as a screening tool. That it works is beyond doubt, however, mammograms are assumed to be specific for breast cancers by both patients and the clinical community.
In reality they miss many cancers, often because the cancers are too small or even precancerous, showing 'shadowing' that may not be indicative of a harmful pathology. Contrary to belief, some cancers are better off left in place as they are not aggressive, usually as they are encased in the ductile tissue of the breast. Only one out of every ten 'positive' mammograms actually turns out to be a cancer that should be treated - a 'false positive'. The problem with false positives is that far too often treatment is given when no such action is necessary, at increased cost to the NHS, and risk to the patient's future health.
Harmful potential
The negative knock-on effects of a mammogram scan are substantial. The invasive, physical nature of the process can cause harm, and increase the chance of healthy tissue becoming damaged or even cancerous in the future. Yet with no precursor to the current scanning system, all women - healthy or not - are put through the rigours of the mammogram.
New technology
A primary scanning alternative would allow women to gain a better understanding of the health of their breasts, without the need for a mammogram. Westhouse Medical is developing BreastCheck - a thermoscanner that detects a wide range of pathologies by analysing and comparing temperature levels in both breasts.
Temperature irregularities can indicate cancer as tumours prompt a build up of capillaries, through which increased blood flow creates heat. Women can use devices like BreastCheck in the comfort of their own home, taking any positive results to their GP who could then advise on further investigation or treatment.
Cost-efficiency
A primary screening procedure such as BreastCheck could save the NHS millions through the avoidance of unnecessary mammograms. At present, there are 2.3 million scans carried out each year, costing the NHS GBP120 million. This figure is predicted to rise during 2013-2014 costing the NHS an additional GBP40 million to accommodate the UK's aging population. According to the Office for National Statistics, the number of people over the age of 85 is expected to more than double from 1.4 million to 3.5 million within 25 years. An older female population will require more mammograms.
This widening footprint indicates that the number of mammograms per year will increase close to three million by 2014. If those 3 million mammograms all cost GBP53.33, ignoring the likely effects of inflation, the cost to the taxpayer will be GBP160m overall.
BreastCheck is a quarter of a mammogram's price. If used as a primary screening device BreastCheck could screen three million women a year at a cost of about GBP37.5 million. If 20 per cent produced positive results, they could be given a mammogram at an additional cost of GBP32 million. This conservative estimate places the total cost for the NHS at GBP70 million, a GBP90 million saving on the estimated GBP160 million forecasted for 2014.
Modernisation
If the NHS as a whole is to restructure, it must modernise its health programmes to continue providing the best possible health service for the public. The NHS's mammogram system has done an incredible job, rising to the challenges posed by a growing disease and saving countless lives. However, with new medical technology, the UK's breast screening programme can be modernised to answer the new problems presented by a recession and changing demographics.
A multi-tiered breast screening programme, beginning with a primary scan, will allow more women to be screened more regularly, more conveniently and in more comfort, with little or no additional health risks. The mammogram would then become a procedure recommended by doctors when abnormalities have already been detected to the benefit of all.
By doing this the NHS will create a flexible, wider and more reliable system where more cancers are detected at a lower cost for the taxpayer.
Contact
Westhouse Medical Services Plc
E: info@westhousemedical.com
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