Breast cancer screening review set up amid fears risks outweigh benefits

An independent investigation into breast cancer screening has been set up by the government's cancer chief to try to settle the growing controversy around its usefulness and potential harms.

Prof Sir Mike Richards's move is an attempt to put to rest the criticisms of a number of scientists, who say the NHS screening programme wrongly identifies cancers that might never harm women, leading to unnecessary and potentially damaging treatment with surgery, drugs and radiation therapy.

They also contest the official NHS position, which is that although there is some over-treatment as a result of screening, mammograms save lives.

Richards's decision came to light in an open letter to Susan Bewley, professor of complex obstetrics at King's College London, who had written to him with her concerns over routine screening.

She herself, she wrote, had decided not to be screened even though she had a family history of breast cancer "as the NHS breast screening programme was not telling the whole truth".

The NHS leaflets on screening, she wrote, "exaggerated benefits and did not spell out the risks. Journals showed a reputable and growing body of international opinion acknowledging that breast cancer screening was not as good as used to be thought.

"The distress of over-diagnosis and decision-making when finding lesions that might (or might not) be cancer that might (or might not) require mutilating surgery is increasingly being exposed. The oft-repeated statement that '1,400 lives a year are saved' has not been subjected to proper scrutiny. Even cancer charities use lower estimates," she wrote.

A big change since the early years of screening is that the NHS is now much better at treating breast cancer, Bewley said. That meant screening is "only of marginal benefit, at best".

The medical profession needed to find ways to cope with the complexity of the issue and the public needed better information, she added.

"Trust is at stake if the public is not told the full story. In the past few years British women have not been told about the genuine doubts. Those millions of women passing through the breast screening treadmill have been unaware of the problems, criticism and real numerical risks they face," she wrote.

In his reply, Richards assured her that he took the current controversy "very seriously".

While he listed the evidence that supports screening – including a World Health Organisation paper from 2002, which said it reduced deaths in 50- to 69-year-old women by 35% – he admitted that he and Harpal Kumar, chief executive of Cancer Research UK, were setting up a review of the breast cancer screening studies. He said they were seeking independent scientists who had not been involved in the controversy to undertake it.

A second independent team was working on an improved screening leaflet that would include both risks and benefits, he said.

He told Bewley he was prepared to make changes to the screening programme if the evidence showed they were necessary.

"Should the independent review conclude that the balance of harms outweighs the benefits of breast screening, I will have no hesitation in referring the findings to the UK national screening committee and then ministers," he wrote.

"You also have my assurance that I am fully committed to the public being given information in a format that they find acceptable and understandable and that enables them to make truly informed choices."

The chief critics of breast screening have been scientists from the reputable Cochrane collaboration, based in the Nordic countries, whose studies of the original trials used to support the introduction of screening have been published in leading medical journals including the British Medical Journal – which on Wednesday will publish the exchange of letters between Richards and Bewley – and the Lancet.

Most of the large-scale trials of screening were flawed, not least because it was hard to assign women randomly to be screened or not. A well-run major trial in Malmo, Sweden, however, produced results that appeared to show screening saved lives.

But in recent years, work by the Nordic Cochrane Collaboration authors has disputed the mortality findings. The most recent paper found that many of the early-stage cancers spotted at screening – too small to be detected other than by x-ray – either would not have gone on to cause problems or might even have regressed.

The day Rentamob warriors hijacked travellers' last stand at Dale Farm

A curly-haired young 'mockney' activist shinned up a telegraph pole and declared loudly to the world: 'I'm very prepared to die here.
'If someone tries to get me down I will pull on this fuse box and be electrocuted.'
One was reminded of Just William's six-year-old friend Violet Elizabeth Bott threatening to 'scream and scream 'til I'm sick'.
'Shame on you, shame on you,' his comrades shouted at the assembled police officers, who seemed not the slightest bit interested in whether the youth was up the pole or not.
Yesterday was a lovely day in rural Essex - or it should have been. The autumnal hues and bright sunshine were marred somewhat by the clatter of helicopters, the yells of combat and the whiff of hypocrisy.
What will be immortalised as the Battle of Dale Farm was in reality an ugly if highly choreographed skirmish. One which will eventually cost the taxpayer more than ￡20million.
As dawn broke, hundreds of police, bailiffs and security guards converged on the illegal travellers’ site to begin the process of their eviction, the culmination of a ten-year legal battle. But as the day unfolded, violently and full of bile, what struck one most was that the event was now hardly about the travellers at all.
The band of anarchists, anti-capitalist activists and other largely middle-class urban warriors who had seized upon the travellers’ cause were there to take on the police and other establishment flunkeys.
What travellers there were present to witness the clash mostly wore an air of resignation. They knew when a battle was lost. For the activists, the battle was the thing they were there for.
Many of today’s headlines will no doubt focus on the Taser fired by officers when scores of police in riot gear stormed into the site before breakfast time.
The officers say they were under ‘direct threat’ of serious violence. Certainly bricks and other heavy objects were thrown at the police by activists in the early stages of their clashes. Other missiles had been hoarded for use elsewhere.
Predictably, the internet was soon alive with accusations of police brutality. Officers are equipped and trained to face potentially fatal missiles, was the gist of one choice remark. It’s their job.

An early PR victory for the anarchists. Once the police had infiltrated the site, bypassing a caravan which had been deliberately set on fire to delay them, the action largely took place on, above and around the 30ft scaffolding tower which the protesters had erected across the main gate.
At least a dozen had made their home on a precarious wooden platform near the top. Most seemed to have chained themselves to the structure. The police and bailiffs would have to remove them before the scaffold could be removed, the gate opened and the site clearance begun in earnest.

This was pure theatre of confrontation. The police – some of whom had been bussed in from as far away as Wales – wore yellow and black. The bailiffs were in blue overalls; the security guards wore orange. Most spent an idle day developing a crick in their necks as they stood and watched the struggle high among the scaffold poles.
One of the more colourful and noisy of the players on the activists’ side was Marina Pepper, a former glamour model turned white witch who, in another life, long ago, once bedded James Bond actor Daniel Craig. Or so she had later claimed.

Manning the barricades in a fake fur, Miss Pepper told the bailiffs: ‘You are evicting them for money. Why is there money for your cruel jobs when there is nothing for schools and hospitals? I don’t know how you will sleep well tonight.’
Some of the other anarchists were sporting freshly shaved heads with a Mohawk strip of hair down the middle. One explained that they had the haircuts because they knew they would be appearing on national TV all day.
Above them all, the sky was full of helicopters. More than I’ve ever seen over an Afghan battlefield. They were not here to find Bubbles the lost African grey parrot, whose forlorn image peered beadily from wanted posters attached to the neighbourhood’s lampposts. It was comforting to know there were other concerns in this corner of Essex.
By lunchtime three large cranes – the police and council officials’ siege engines – had been moved into place. At 1.46pm, a yellow cherrypicker containing the police’s ‘forlorn hope’ advance party was placed alongside the scaffold and the first officer stepped across to be met a volley of abuse. More followed.
The protesters joined hands and the wooden platform – made only of pallets and aged planks – began to sag a little alarmingly under the combined weights of the plucky freedom fighters and their brutal capitalist oppressors. A number of breeze blocks, loose scaffolding poles and other potential missiles were dropped to the ground from the scaffold top by the police spearhead. A ragged chant of ‘We won’t go’ was raised from the top platform, supported by the protesters on terra firma.
‘Endemic racism of this government ... ethnic cleansing,’ roared one of the young men from on high, though it was hard to hear him because of the helicopters.
A white crane delivered two bailiffs in a cage. ‘Get your f***ing hands off her,’ someone screamed.
‘They are deliberately finding places which hurt the most and putting their fingers there,’ one of the scaffold protesters yelled bathetically to the audience below.

But even rough tickling would not move them. Soon, a concerted police effort to grapple the scaffold and engage the defenders began. At 2.50, the first two protesters, both secured in plastic manacles, were removed via the cherrypicker.
One, who appeared to be chained by the neck to a scaffolding pole, was released by a policeman wielding an angle grinder. Other officers or bailiffs in the cherrypicker or dangling from slings on the end of a crane were busy with tools, dismantling the scaffolding frame from the top down.
The activists did not like this, chanting: ‘It’s not safe and sound/get the pigs back on the ground!’
‘Health and safety!’ someone even yelled, accusingly and in all earnestness, at the police who were trying to remove those who had made their homes atop the scaffolding. ‘Where were you when London was burning?’ sneered a female traveller, as yet another platoon of bored riot police filed past. ‘I’ll tell you,’ she added helpfully. ‘Peeing your pants.’
As the afternoon wore on, more protesters were removed from the scaffolding. Unwilling to be detained, some began to abandon the top of their own accord, once the police had cut the chains that shackled them to the poles. ‘Aaargh, you are strangling me,’ yelled another as he was being transferred from the scaffold to the cherrypicker. Was he being strangled? It was hard to say from below.
But it made great theatre for the world’s TV crews. And that was the job done as far as the Dale Farm activists were concerned.

Gilad Shalit deal opposed by families of Palestinian prisoners' victims

Israel's prime minister, Binyamin Netanyahu, has told the families of Israelis killed by some of the 1,027 Palestinian prisoners due to be swapped for the captured soldier Gilad Shalit that he "shares their pain in seeing their loved ones' murderers freed" but had little choice.

Netanyahu justified the deal with Hamas in a letter delivered shortly before the relatives of victims of suicide bombings and other attacks asked the high court in Jerusalem to block the exchange. Shalit, 25, has been held incommunicado in Gaza for more than five years.

Netanyahu said he knew "the price was very heavy" for relatives of the victims. He added that the decision was among the most difficult he had ever made, because he lost a brother in the conflict with the Palestinians.

But he said he "was faced with the responsibility of the prime minister of Israel to bring home every soldier who is sent to protect our citizens".

Critics say the agreement with Hamas is not only a concession to terrorists but will encourage the Palestinians to abduct more soldiers. Some say it is little different from a deal opposed by Netanyahu two years ago before he became prime minister.

Palestinians being freed include the founders of Hamas's armed wing and the organisers of suicide bombings and other attacks in which scores of Israeli civilians, including children and teenagers, were killed. They include the bombings of a Jerusalem pizza restaurant frequented by families, a Tel Aviv nightclub popular with young Russian immigrants and a Netanya hotel.

There were angry scenes inside and outside the high court where the proceedings were repeatedly interrupted by family members yelling objections to the deal with Hamas.

Shvuel Schijveschuurder, who lost his parents and three siblings in a suicide bomb at a Jerusalem pizza restaurant 10 years ago, shouted at Shalit's father, Noam, telling him to hang a black flag on his home because "this is a day of mourning".

Schijveschuurder was arrested last week after vandalising the memorial to the assassinated Israeli prime minister, Yitzhak Rabin, who reached the Oslo peace accords with the Palestinians. He painted "release Yigal Amir" – the name of the Jewish extremist who murdered Rabin – on the memorial.

Yossi Zur asked the high court to block the release of the Palestinians who killed his son and 16 other people in a suicide attack on a bus in Haifa in 2003 because it would only encourage further attacks..

"From our experience with past deals, and sadly we have a lot of experience, we know how many Israelis will be killed as a result of the release of these terrorists. I am here to protect my children who are still alive," he told Israeli television.

Shalit's father said they sympathised with the victims' pain, but asked the court not to interfere in the agreement. "Not implementing the deal will not return the murdered loved ones while, on the other hand, it would sentence Gilad to death."

The president of the high court, Dorit Beinisch, said he recognised the government's agreement with Hamas meant the negation of legal decisions to jail the Palestinian prisoners. "The moral and legal difficulty is laid out before us … we are sitting among our own people. There is no need to explain the painful history and the very difficult dilemmas we face."

The government told the court that the exchange is a political matter which it is authorised to carry out, as recognised by the failure of legal challenges in similar cases before.

"The court has refused, time after time, to interfere with the release of prisoners as part of a deal reached through political negotiations," the government told the court.

A ruling was expected on Monday evening. If the court does not block it, the handover will take place in stages. Israel will first release 27 Palestinian women prisoners. Shalit, a corporal who was promoted to sergeant major while in captivity, will then be moved from Gaza in to southern Israel, possibly directly through one of the crossings between the two territories or briefly via Egypt. Israel will then release 450 male prisoners to Gaza and the West Bank, aside from a small number destined for exile in Turkey and other countries in the region.

The remainder of the 1,027 Palestinians are to be freed in the coming weeks.

Netanyahu, his defence minister, Ehud Barak, and senior military officers will greet Shalit at an air force base in the south of the country. He will undergo a medical examination and then be flown to his parents' home in Mitzpe Hila, near Israel's border with Lebanon.

Shalit was captured by Palestinians who tunnelled from Gaza into Israel and killed two other members of his tank crew before snatching him.

Cain’s style: Simple solutions and a willingness to say ‘I don’t know’

He opposes abortion, including in cases of rape and incest. He thinks Iran could be deterred from aggression by deploying more warships. And he is a proponent of privatized Social Security.

But just one topic — his “9-9-9” tax plan — has dominated Herman Cain’s rhetoric in this presidential race, helping to propel him to the top of Republican polls this month.
And that has prompted questions about what else he stands for and whether he has the breadth of knowledge — particularly on foreign policy — expected of an occupant of the White House.

An examination of Cain’s words — his remarks as a radio talk-show host, as well as his writings, interviews and speeches — shows a man thoroughly steeped in conservative ideology. He has said that climate change is a scam, that he would not have survived cancer under the Obama administration’s health-care overhaul, and that the United States is on the brink of a socialist takeover.

In the style of an evangelist who can bring audiences to their feet, Cain has used his soapboxes to rebut criticism of the tea party movement, berate liberals and President Obama, and defend conservatives and Republicans against accusations of racism.

Reforming the tax code has been a keen interest since his days as the chief executive of Godfather’s Pizza in the 1990s. But outside of his tax ideas, Cain rarely gets into specifics. That is partly in keeping with his style of connecting with voters by communicating his ideas in basic, catchy terms.

“If you understand the simple concepts,” Cain writes in his recently published book, quoting an old teacher, “you will be able to deal with the complex concepts.”

It is also in keeping with his candor and the everyman persona he has cultivated on the campaign trail. Conservative audiences have found something compelling in his story, that of an African American who grew up in the segregated South and rose to become a successful business executive. And they have been energized by his passionate, humor-laced speeches.

In recent interviews, Cain has called it hubris to claim to know the minutiae of every major issue.

He has extolled the importance of leaders surrounding themselves with able advisers (though he has demurred when asked who his advisers are). He has shown repeatedly that, when faced with a tough question, he is not afraid to admit he doesn’t know the answer.

Asked during a campaign stop in New Hampshire this week about a specific deduction under his tax plan, he replied: “I have no idea. But it’s a good question.”

Cain offers a nine-page position paper he calls the “Cain Doctrine” in his book, “This is Herman Cain! My Journey to the White House,” which was published this month. In it, he proposes empowering states to resolve on their own challenges with illegal immigration, promoting greater domestic energy production and encouraging vigilance against the Islamic principles known as sharia law, which he warns could “seep into American life.”

He pledges support for Israel, but says he has too little information to opine on the war in Afghanistan or on events unfolding in other nations.

'Hold their feet to the fire': Obama faces demands for tough reprisals against Iran after U.S. foils plot to murder Saudi ambassador in D.C.

House Speaker John Boehner today called on Obama to 'hold Iran's feet to the fire' in the wake of the thwarting of a 'significant terrorist act' by agents working for the Iranian government to assassinate the Saudi ambassador to America in Washington DC.
The Republican leader led calls for the President to take swift and decisive action against the Ahmadinejad administration after the discovery of the plot, which Mr Boehner called 'a very serious breach of international behaviour'.
Vice President Joe Biden this morning said that 'nothing has been taken off the table' as the U.S. discusses possible sanctions and military action. He said the consequences for Iran will be 'serious'.
Manssor Arbabsiar, a 56-year-old U.S. citizen who also holds an Iranian passport, appeared in court in New York last night accused of trying to hire a Mexican drugs cartel to carry out the killing.
He is accused of plotting to kill Adel Al-Jubeir by bombing a restaurant, before setting off blasts at the Saudi and Israeli embassies.
The devastating plan was foiled after Arbabsiar offered a government informant posing as a Mexican drug cartel associate a $1.5 million bounty to help carry out the attack.
New details emerged tonight about the informant who helped uncover the plan, which could have cause catastrophic damage if it had been successful.
The man, known by the codename CS-1, was posing as a member of the feared Zetas drug cartel, reported ABC News.
The Zetas have have been behind some of the worst violence in Mexico's drug war, including mass beheadings, the murder of a U.S. immigration official, and the arson of a Monterrey casino that trapped and killed 52.
Government officials revealed that the informant had been busted by the Drug Enforcement Agency for drug trafficking and had become a source that had helped make arrests in drugs cases.
Rhetoric against Iran is building today as the U.S. is poised to taken an even stronger stance against Tehran.
Mr Biden said that it was 'an outrageous act and the Iranians are going to have to be held accountable.
'The first thing we're going to be doing is making sure the entire world and all the capitals of the world understand what exactly the Iranians had in mind,' he told Good Morning America.
'It's an outrage that violates one of the fundamental premises upon which nations deal with one another, and that is the sanctity and safety of their diplomats.
Republican chairman of the House Homeland Security Committee Peter King said that the 'flagrant and notorious' plot was 'an act of war' and that military action could not be ruled out.
'We should not be... automatically saying we're not going to have military action,' he told CNN.
'Everything should be left on the table when you are talking about a potential attack [in] the United States, an act of war.'
A former chief of Saudi intelligence services said evidence that Iran was behind a plot to kill the Saudi Arabian ambassador to Washington was overwhelming.   
Saudi Prince Turki al-Faisal said: 'The burden of proof is overwhelming, and clearly shows official Iranian responsibility for this. Somebody in Iran will have to pay the price.'
A spokesman for British Prime Minister David Cameron said that Britain is consulting with the U.S. on action against Iran.
'We are in close touch with the U.S. authorities and we will support measures to hold Iran accountable for its actions,' he said.
Last night Secretary of State Hillary Clinton said the plot 'crosses a line' in Iran's state sponsorship of terrorism and will further isolate the Islamic republic.
Mrs Clinton said: 'This really, in the minds of many diplomats and government officials, crosses a line that Iran needs to be held to account for.'
'The idea that they would attempt to go to a Mexican drug cartel to solicit murder-for-hire to kill the Saudi ambassador, nobody could make that up, right?' she said.
Clinton said the scheme 'creates a potential for international reaction that will further isolate Iran, that will raise questions about what they're up to, not only in the United States and Mexico'.
Arbabsiar and another man, Gholam Shakuri, have been charged with the $1.5 million terror plot.
Shakuri, whom authorities said was a member of the Quds Force, a branch of the Iranian Islamic Revolutionary Guard Corps, is still at large.
A third man named Abdul-Reza Shahlai is accused of coordinating the alleged plot.
Shahlai, an Iranian official who is Arbabsiar's cousin, has previously been accused of plotting an attack in Iraq which killed five U.S. soldiers.
Arbabsiar's wife, Martha Guerrero, last night said that he was wrongly accused.
'I may not be living with him being separated, but I cannot for the life of me think that he would be capable of doing that,' she told local station KVUE.
'He was at the wrong place at the wrong time. I'm sure of that.'
Iranian officials have laughed off the accusation that it was a plot backed by the government in Tehran.
Shocking details of the plot have emerged as authorities reveal the scale of the operation to foil the attack.
According to prosecutors, when asked by undercover agents about the potential loss of innocent life in the bombings, Arbabsiar replied, 'They want that guy [al-Jubeir] done.
'If the hundred go with him, f**k 'em.'
Attorney General Eric Holder said: 'The criminal complaint unsealed today exposes a deadly plot directed by factions of the Iranian government to assassinate a foreign Ambassador on U.S. soil with explosives.
Arbabsiar was arrested on September 29 in New York at JFK airport, according to Holder.
He was working for the Iranian Islamic Revolutionary Guard and had confessed to a plot.
Officials said he had flown from Iran to Mexico City, via Frankfurt, but had been refused entry to Mexico and had been put on a plane to New York.
Mexico worked closely with U.S. authorities to help foil the alleged plot - issuing an immigration alert on Arbabsiar after U.S. authorities told Mexican counterparts that he was the subject of an arrest warrant.
Julian Ventura, undersecretary for North America, said the alert prompted Mexican immigration officials to turn Arbabsiar away when he tried to enter Mexico on September 28.
Arbabsiar was arrested the next day when he arrived at New York's Kennedy International Airport.
After his arrest, Arbabsiar made phone calls to Shakuri in Iran which were monitored.  During the calls, Shakuri allegedly confirmed that Arbabsiar should move forward with the plot to murder the Ambassador and that he should accomplish the task as quickly as possible, stating on October 5, 2011, 'Just do it quickly, it’s late.'
Bombings of the Saudi and Israeli embassies in Buenos Aires and Argentina were also discussed as part of the plan, according to officials.
Shakuri, who is based in Iran, remains at large.
He is a member of Iran’s Quds Force, a special operations unit of the Iranian Islamic Revolutionary Guard Corps (IRGC), which sponsors and promotes terrorist activities abroad.   
The Treasury, meanwhile, identified the Iranian official coordinating the plot as, Abdul-Reza Shahlai, a cousin of Arbabsiar.
Shahlai was three years ago identified as a terrorist by the U.S. Government for organising violence in Iraq.
He is said to have worked with the anti-U.S. Mahdi Army to attack soldiers.
In one of the attacks he is alleged to have planned in January 2007, up to a dozen fighters infiltrated a government building in Karbala, dressed as American security officers.