Controversies in the mammography screening programme in Switzerland.

Recently, the Swiss Medical Board [1] issued a report stating that systematic mammography screening programmes for early detection of breast cancer are no longer reasonable for women to attend. A systematic review of the existing literature allowed the Board to conclude that the effectiveness of mammography is still uncertain, over-diagnosis and false positive tests cause harm, and the screening programmes have an unfavourable cost-effectiveness ratio. In response to these new recommendations, prominent Swiss personalities, experts and organisations have expressed their opinion, considering the report as “flawed and misleading” and that it could confuse women and cost their lives. Moreover, a review [2], published simultaneously with the report of the Swiss Medical Board, presented a completely opposite view of routine breast cancer screening by declaring that its benefits outweighed its harms. This is not the first time that in Switzerland, as in other countries, controversy over the effectiveness of mammograms and other cancer screening method (prostate cancer) has been debated. Only a few cancer screening tests have proven to be effective by reducing mortality (Pap smears or