Who does not benefit from our national breast screening programme and who should have oversight?

The recent report on the delays for mammography encountered by women in the Wellington Region reminds us that the organisation of cancer screening is far from straightforward, and we highlight these complexities in our viewpoint article. Screening can reduce mortality from cancer, but it is costly, and the benefits are many years in the future. Cancer screening can result in some individuals being over-diagnosed and over-treated, can impact on the services for symptomatic patients and can exacerbate inequities. Reviewing the quality, safety and acceptability of our breast screening programme is important but there is a need to acknowledge the role of the resulting clinical services, including the opportunity cost to symptomatic patients who seek healthcare in the same system.