Has Screening Mammography Become Obsolete?
| Autor: | Mary E. Costanza |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Screening mammography Breast cancer mortality media_common.quotation_subject Alternative medicine Annual Screening Family medicine Cancer screening Commentary medicine Retrenchment Mammography Quality (business) business media_common |
| Zdroj: | Current Oncology Volume 22 Issue 5 Pages 2879-331 |
| ISSN: | 1718-7729 |
| Popis: | With so much debate about the value of screening mammography and with the emergence of newer technologies, it seems reasonable to ask whether screening mammography, as we know it, has become obsolete. Some believe that mammography is associated with so many harms that retrenchment from the years of screening advocacy is the only sensible path. Since 2009, guidelines from the U.S. Preventive Services Task Force (uspstf)1 have emphasized the negative balance of annual screening and screening before age 50 and after age 74. Others believe that the positive aspects of screening—a 20%–30% reduction in breast cancer mortality reported by European trials dating to the early 1990s—demonstrate that benefits outweigh harms. The latest review of screening pros and cons by the International Agency for Research on Cancer2 is worth noting. The uspstf update is due soon, but drafts of the proposed update suggest no major changes from the 2009 guideline3. The quality of randomized studies using a “no screening” control has been debated for more than 20 years. There are really no new discussions that will change anyone’s mind. New trials are unlikely because of the ethical impossibility of having a control group that is denied a proven screening technology (mammography), the length of time required to follow participants, and the costs of large studies. But several areas of controversy seem to me to be useful to reconsider: namely, the balance of benefits to harms, and more importantly, the benefits or harms included in any given study. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|