Examining breast cancer screening recommendations in Canada: The projected resource impact of screening among women aged 40-49.

Autor:	Basmadjian RB; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Ruan Y; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Hutchinson JM; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Warkentin MT; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Alagoz O; Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA.; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA., Coldman A; British Columbia Cancer Control Research, Vancouver, British Columbia, Canada., Brenner DR; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Jazyk:	angličtina
Zdroj:	Journal of medical screening [J Med Screen] 2024 Aug 06, pp. 9691413241267845. Date of Electronic Publication: 2024 Aug 06.
DOI:	10.1177/09691413241267845
Abstrakt:	Objective: To quantify the resource use of revising breast cancer screening guidelines to include average-risk women aged 40-49 years across Canada from 2024 to 2043 using a validated microsimulation model. Setting: OncoSim-Breast microsimulation platform was used to simulate the entire Canadian population in 2015-2051. Methods: We compared resource use between current screening guidelines (biennial screening ages 50-74) and alternate screening scenarios, which included annual and biennial screening for ages 40-49 and ages 45-49, followed by biennial screening ages 50-74. We estimated absolute and relative differences in number of screens, abnormal screening recalls without cancer, total and negative biopsies, screen-detected cancers, stage of diagnosis, and breast cancer deaths averted. Results: Compared with current guidelines in Canada, the most intensive screening scenario (annual screening ages 40-49) would result in 13.3% increases in the number of screens and abnormal screening recalls without cancer whereas the least intensive scenario (biennial screening ages 45-49) would result in a 3.4% increase in number of screens and 3.8% increase in number of abnormal screening recalls without cancer. More intensive screening would be associated with fewer stage II, III, and IV diagnoses, and more breast cancer deaths averted. Conclusions: Revising breast cancer screening in Canada to include average-risk women aged 40-49 would detect cancers earlier leading to fewer breast cancer deaths. To realize this potential clinical benefit, a considerable increase in screening resources would be required in terms of number of screens and screen follow-ups. Further economic analyses are required to fully understand cost and budget implications. Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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