The Impact of Cancer Screening on All-Cause Mortality
Autor: | Andreas Stang, Karl-Heinz Jöckel |
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Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Breast cancer mortality Health Promotion 03 medical and health sciences 0302 clinical medicine Cause of Death Germany Neoplasms Cancer screening Medicine Humans 030212 general & internal medicine Early Detection of Cancer medicine.diagnostic_test business.industry Public health Age Factors Cancer Sigmoidoscopy General Medicine medicine.disease Confidence interval United Kingdom Sample size determination 030220 oncology & carcinogenesis Original Article business All cause mortality Demography |
Zdroj: | Deutsches Arzteblatt international. 115(29-30) |
ISSN: | 1866-0452 |
Popis: | Background It is a matter of debate whether, and if so, to what extent, cancer screening programs reduce all-cause mortality. Against this backdrop, we analyzed potential effects of several cancer screening approaches on all-cause mortality in two representative Western European populations. Methods We used mortality data from the UK (England &Wales) and Germany from 2015 and published figures from screening studies on relative reduction in mortality for screened cancers to calculate the expected decline in all-cause mortality in these countries. We determined the required sample size for demonstrating a 3% reduction in all-cause mortality with a narrow (95%) confidence interval in a hypothetical screening trial. Results A relative 20% reduction in breast cancer mortality can be accompanied by a maximum 1.7-1.8% reduction in all-cause mortality in England & Wales and Germany, respectively. Expected declines are smaller for sigmoidoscopy screening (1.0-1.2%), prostate-specific antigen (PSA) screening (0.4-0.6%), and skin cancer screening (0.2%). To obtain a 95% confidence interval of +/-1% for demonstrating a 3% decline in all-cause mortality, a study size of 596 200 persons is required. Conclusion Because the proportion of cancer deaths in all deaths in Western Europe is relatively low, cancer screening procedures can reduce all-cause mortality by only 1-3%. However, this reduction is relevant to public health. |
Databáze: | OpenAIRE |
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