Trade-Offs Between Harms and Benefits of Different Breast Cancer Screening Intervals Among Low-Risk Women
| Autor: | John M. Hampton, Jeanne S. Mandelblatt, Amy Trentham-Dietz, Brian L. Sprague, Jeroen J. van den Broek, Clyde B. Schechter, Diana L. Miglioretti, Karla Kerlikowske, Nicolien T. van Ravesteyn, Natasha K. Stout, Harry J. de Koning, Anna N.A. Tosteson, Oguzhan Alagoz |
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| Přispěvatelé: | Public Health |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Risk
Cancer Research medicine.medical_specialty Oncology and Carcinogenesis Breast Neoplasms 03 medical and health sciences Breast cancer screening 0302 clinical medicine Breast cancer SDG 3 - Good Health and Well-being Clinical Research Breast Cancer medicine Humans Mass Screening False Positive Reactions Oncology & Carcinogenesis 030212 general & internal medicine Breast density Overdiagnosis skin and connective tissue diseases Early Detection of Cancer Breast Cancer Surveillance Consortium and the Cancer Intervention and Surveillance Modeling Network Cancer Aged medicine.diagnostic_test Obstetrics business.industry Prevention Trade offs Articles Health Services Middle Aged medicine.disease Quality-adjusted life year Oncology 030220 oncology & carcinogenesis Relative risk Female AcademicSubjects/MED00010 business Mammography |
| Zdroj: | Journal of the National Cancer Institute, 113(8), 1017-1026. Oxford University Press JNCI Journal of the National Cancer Institute Journal of the National Cancer Institute, vol 113, iss 8 |
| ISSN: | 0027-8874 |
| Popis: | Background A paucity of research addresses breast cancer screening strategies for women at lower-than-average breast cancer risk. The aim of this study was to examine screening harms and benefits among women aged 50-74 years at lower-than-average breast cancer risk by breast density. Methods Three well-established, validated Cancer Intervention and Surveillance Network models were used to estimate the lifetime benefits and harms of different screening scenarios, varying by screening interval (biennial, triennial). Breast cancer deaths averted, life-years and quality-adjusted life-years gained, false-positives, benign biopsies, and overdiagnosis were assessed by relative risk (RR) level (0.6, 0.7, 0.85, 1 [average risk]) and breast density category, for US women born in 1970. Results Screening benefits decreased proportionally with decreasing risk and with lower breast density. False-positives, unnecessary biopsies, and the percentage overdiagnosis also varied substantially by breast density category; false-positives and unnecessary biopsies were highest in the heterogeneously dense category. For women with fatty or scattered fibroglandular breast density and a relative risk of no more than 0.85, the additional deaths averted and life-years gained were small with biennial vs triennial screening. For these groups, undergoing 4 additional screens (screening biennially [13 screens] vs triennially [9 screens]) averted no more than 1 additional breast cancer death and gained no more than 16 life-years and no more than 10 quality-adjusted life-years per 1000 women but resulted in up to 232 more false-positives per 1000 women. Conclusion Triennial screening from age 50 to 74 years may be a reasonable screening strategy for women with lower-than-average breast cancer risk and fatty or scattered fibroglandular breast density. |
| Databáze: | OpenAIRE |
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