Evidence for reducing cancer-specific mortality due to screening for breast cancer in Europe: A systematic review
The aim of this study was to quantify the impact of organised mammography screening on breast cancer mortality across European regions. Therefore, a systematic review was performed including different types of studies from all European regions and stringently used clearly defined quality appraisal t...
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| Published in: | European journal of cancer (1990) Vol. 127; pp. 191 - 206 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Elsevier Ltd
01.03.2020
Elsevier Science Ltd |
| Subjects: | |
| ISSN: | 0959-8049, 1879-0852, 1879-0852 |
| Online Access: | Get full text |
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| Abstract | The aim of this study was to quantify the impact of organised mammography screening on breast cancer mortality across European regions. Therefore, a systematic review was performed including different types of studies from all European regions and stringently used clearly defined quality appraisal to summarise the best evidence.
Six databases were searched including Embase, Medline and Web of Science from inception to March 2018. To identify all eligible studies which assessed the effect of organised screening on breast cancer mortality, two reviewers independently applied predefined inclusion and exclusion criteria. Original studies in English with a minimum follow-up of five years that were randomised controlled trials (RCTs) or observational studies were included. The Cochrane risk of bias instrument and the Newcastle–Ottawa Scale were used to assess the risk of bias.
Of the 5015 references initially retrieved, 60 were included in the final analysis. Those comprised 36 cohort studies, 17 case–control studies and 7 RCTs. None were from Eastern Europe. The quality of the included studies varied: Nineteen of these studies were of very good or good quality. Of those, the reduction in breast cancer mortality in attenders versus non-attenders ranged between 33% and 43% (Northern Europe), 43%–45% (Southern Europe) and 12%–58% (Western Europe). The estimates ranged between 4% and 31% in invited versus non-invited.
This systematic review provides evidence that organised screening reduces breast cancer mortality in all European regions where screening was implemented and monitored, while quantification is still lacking for Eastern Europe. The wide range of estimates indicates large differences in the evaluation designs between studies, rather than in the effectiveness of screening.
•Study summarises current evidence of mortality reduction due to mammography screening.•Includes different types of studies, using a methodologically sound quality appraisal.•Impact ranges between 12% and 58% in screening attenders versus non-attenders.•Impact ranges between 4% and 31% in invited versus non-invited women.•Quantification of the actual effects is still lacking for Eastern Europe.•Results fortify that mammography screening reduces mortality from breast cancer. |
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| AbstractList | The aim of this study was to quantify the impact of organised mammography screening on breast cancer mortality across European regions. Therefore, a systematic review was performed including different types of studies from all European regions and stringently used clearly defined quality appraisal to summarise the best evidence.BACKGROUNDThe aim of this study was to quantify the impact of organised mammography screening on breast cancer mortality across European regions. Therefore, a systematic review was performed including different types of studies from all European regions and stringently used clearly defined quality appraisal to summarise the best evidence.Six databases were searched including Embase, Medline and Web of Science from inception to March 2018. To identify all eligible studies which assessed the effect of organised screening on breast cancer mortality, two reviewers independently applied predefined inclusion and exclusion criteria. Original studies in English with a minimum follow-up of five years that were randomised controlled trials (RCTs) or observational studies were included. The Cochrane risk of bias instrument and the Newcastle-Ottawa Scale were used to assess the risk of bias.METHODSSix databases were searched including Embase, Medline and Web of Science from inception to March 2018. To identify all eligible studies which assessed the effect of organised screening on breast cancer mortality, two reviewers independently applied predefined inclusion and exclusion criteria. Original studies in English with a minimum follow-up of five years that were randomised controlled trials (RCTs) or observational studies were included. The Cochrane risk of bias instrument and the Newcastle-Ottawa Scale were used to assess the risk of bias.Of the 5015 references initially retrieved, 60 were included in the final analysis. Those comprised 36 cohort studies, 17 case-control studies and 7 RCTs. None were from Eastern Europe. The quality of the included studies varied: Nineteen of these studies were of very good or good quality. Of those, the reduction in breast cancer mortality in attenders versus non-attenders ranged between 33% and 43% (Northern Europe), 43%-45% (Southern Europe) and 12%-58% (Western Europe). The estimates ranged between 4% and 31% in invited versus non-invited.RESULTSOf the 5015 references initially retrieved, 60 were included in the final analysis. Those comprised 36 cohort studies, 17 case-control studies and 7 RCTs. None were from Eastern Europe. The quality of the included studies varied: Nineteen of these studies were of very good or good quality. Of those, the reduction in breast cancer mortality in attenders versus non-attenders ranged between 33% and 43% (Northern Europe), 43%-45% (Southern Europe) and 12%-58% (Western Europe). The estimates ranged between 4% and 31% in invited versus non-invited.This systematic review provides evidence that organised screening reduces breast cancer mortality in all European regions where screening was implemented and monitored, while quantification is still lacking for Eastern Europe. The wide range of estimates indicates large differences in the evaluation designs between studies, rather than in the effectiveness of screening.CONCLUSIONThis systematic review provides evidence that organised screening reduces breast cancer mortality in all European regions where screening was implemented and monitored, while quantification is still lacking for Eastern Europe. The wide range of estimates indicates large differences in the evaluation designs between studies, rather than in the effectiveness of screening. The aim of this study was to quantify the impact of organised mammography screening on breast cancer mortality across European regions. Therefore, a systematic review was performed including different types of studies from all European regions and stringently used clearly defined quality appraisal to summarise the best evidence. Six databases were searched including Embase, Medline and Web of Science from inception to March 2018. To identify all eligible studies which assessed the effect of organised screening on breast cancer mortality, two reviewers independently applied predefined inclusion and exclusion criteria. Original studies in English with a minimum follow-up of five years that were randomised controlled trials (RCTs) or observational studies were included. The Cochrane risk of bias instrument and the Newcastle-Ottawa Scale were used to assess the risk of bias. Of the 5015 references initially retrieved, 60 were included in the final analysis. Those comprised 36 cohort studies, 17 case-control studies and 7 RCTs. None were from Eastern Europe. The quality of the included studies varied: Nineteen of these studies were of very good or good quality. Of those, the reduction in breast cancer mortality in attenders versus non-attenders ranged between 33% and 43% (Northern Europe), 43%-45% (Southern Europe) and 12%-58% (Western Europe). The estimates ranged between 4% and 31% in invited versus non-invited. This systematic review provides evidence that organised screening reduces breast cancer mortality in all European regions where screening was implemented and monitored, while quantification is still lacking for Eastern Europe. The wide range of estimates indicates large differences in the evaluation designs between studies, rather than in the effectiveness of screening. Background The aim of this study was to quantify the impact of organised mammography screening on breast cancer mortality across European regions. Therefore, a systematic review was performed including different types of studies from all European regions and stringently used clearly defined quality appraisal to summarise the best evidence. Methods Six databases were searched including Embase, Medline and Web of Science from inception to March 2018. To identify all eligible studies which assessed the effect of organised screening on breast cancer mortality, two reviewers independently applied predefined inclusion and exclusion criteria. Original studies in English with a minimum follow-up of five years that were randomised controlled trials (RCTs) or observational studies were included. The Cochrane risk of bias instrument and the Newcastle–Ottawa Scale were used to assess the risk of bias. Results Of the 5015 references initially retrieved, 60 were included in the final analysis. Those comprised 36 cohort studies, 17 case–control studies and 7 RCTs. None were from Eastern Europe. The quality of the included studies varied: Nineteen of these studies were of very good or good quality. Of those, the reduction in breast cancer mortality in attenders versus non-attenders ranged between 33% and 43% (Northern Europe), 43%–45% (Southern Europe) and 12%–58% (Western Europe). The estimates ranged between 4% and 31% in invited versus non-invited. Conclusion This systematic review provides evidence that organised screening reduces breast cancer mortality in all European regions where screening was implemented and monitored, while quantification is still lacking for Eastern Europe. The wide range of estimates indicates large differences in the evaluation designs between studies, rather than in the effectiveness of screening. The aim of this study was to quantify the impact of organised mammography screening on breast cancer mortality across European regions. Therefore, a systematic review was performed including different types of studies from all European regions and stringently used clearly defined quality appraisal to summarise the best evidence. Six databases were searched including Embase, Medline and Web of Science from inception to March 2018. To identify all eligible studies which assessed the effect of organised screening on breast cancer mortality, two reviewers independently applied predefined inclusion and exclusion criteria. Original studies in English with a minimum follow-up of five years that were randomised controlled trials (RCTs) or observational studies were included. The Cochrane risk of bias instrument and the Newcastle–Ottawa Scale were used to assess the risk of bias. Of the 5015 references initially retrieved, 60 were included in the final analysis. Those comprised 36 cohort studies, 17 case–control studies and 7 RCTs. None were from Eastern Europe. The quality of the included studies varied: Nineteen of these studies were of very good or good quality. Of those, the reduction in breast cancer mortality in attenders versus non-attenders ranged between 33% and 43% (Northern Europe), 43%–45% (Southern Europe) and 12%–58% (Western Europe). The estimates ranged between 4% and 31% in invited versus non-invited. This systematic review provides evidence that organised screening reduces breast cancer mortality in all European regions where screening was implemented and monitored, while quantification is still lacking for Eastern Europe. The wide range of estimates indicates large differences in the evaluation designs between studies, rather than in the effectiveness of screening. •Study summarises current evidence of mortality reduction due to mammography screening.•Includes different types of studies, using a methodologically sound quality appraisal.•Impact ranges between 12% and 58% in screening attenders versus non-attenders.•Impact ranges between 4% and 31% in invited versus non-invited women.•Quantification of the actual effects is still lacking for Eastern Europe.•Results fortify that mammography screening reduces mortality from breast cancer. |
| Author | McKee, Martin Priaulx, Jennifer Jansen, Erik E.L. Pitter, Janos van Ravesteyn, Nicolien T. Segnan, Nereo de Koning, Harry Ivanus, Urska Zielonke, Nadine Senore, Carlo van Ballegooijen, Marjolein Mlakar, Dominika Novak Primic-Žakelj, Maja Heinävaara, Sirpa Jansen, Erik Lansdorp – Vogelaar, Iris Anttila, Ahti Veerus, Piret Voko, Zoltan Minozzi, Silvia Ponti, Antonio Jarm, Katja Heijnsdijk, Eveline A.M. Cañada, Marcell de Koning, Harry J. Sarkeala, Tytti Heijnsdijk, Eveline Széles, György Driesprong - de Kok, Inge van Ravesteyn, Nicolien Gini, Andrea |
| Author_xml | – sequence: 1 givenname: Nadine surname: Zielonke fullname: Zielonke, Nadine email: n.zielonke@erasmusmc.nl organization: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands – sequence: 2 givenname: Andrea surname: Gini fullname: Gini, Andrea organization: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands – sequence: 3 givenname: Erik E.L. surname: Jansen fullname: Jansen, Erik E.L. organization: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands – sequence: 4 givenname: Ahti surname: Anttila fullname: Anttila, Ahti organization: Finnish Cancer Registry, Helsinki, Finland – sequence: 5 givenname: Nereo surname: Segnan fullname: Segnan, Nereo organization: Epidemiology and Screening Unit – CPO, University Hospital Città della Salute e della Scienza, Turin, Italy – sequence: 6 givenname: Antonio surname: Ponti fullname: Ponti, Antonio organization: Epidemiology and Screening Unit – CPO, University Hospital Città della Salute e della Scienza, Turin, Italy – sequence: 7 givenname: Piret surname: Veerus fullname: Veerus, Piret organization: National Institute for Health Development, Tallinn, Estonia – sequence: 8 givenname: Harry J. surname: de Koning fullname: de Koning, Harry J. organization: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands – sequence: 9 givenname: Nicolien T. surname: van Ravesteyn fullname: van Ravesteyn, Nicolien T. organization: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands – sequence: 10 givenname: Eveline A.M. surname: Heijnsdijk fullname: Heijnsdijk, Eveline A.M. organization: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands – sequence: 11 givenname: Piret surname: Veerus fullname: Veerus, Piret – sequence: 12 givenname: Ahti surname: Anttila fullname: Anttila, Ahti – sequence: 13 givenname: Sirpa surname: Heinävaara fullname: Heinävaara, Sirpa – sequence: 14 givenname: Tytti surname: Sarkeala fullname: Sarkeala, Tytti – sequence: 15 givenname: Marcell surname: Cañada fullname: Cañada, Marcell – sequence: 16 givenname: Janos surname: Pitter fullname: Pitter, Janos – sequence: 17 givenname: György surname: Széles fullname: Széles, György – sequence: 18 givenname: Zoltan surname: Voko fullname: Voko, Zoltan – sequence: 19 givenname: Silvia surname: Minozzi fullname: Minozzi, Silvia – sequence: 20 givenname: Nereo surname: Segnan fullname: Segnan, Nereo – sequence: 21 givenname: Carlo surname: Senore fullname: Senore, Carlo – sequence: 22 givenname: Marjolein surname: van Ballegooijen fullname: van Ballegooijen, Marjolein – sequence: 23 givenname: Inge surname: Driesprong - de Kok fullname: Driesprong - de Kok, Inge – sequence: 24 givenname: Andrea surname: Gini fullname: Gini, Andrea – sequence: 25 givenname: Eveline surname: Heijnsdijk fullname: Heijnsdijk, Eveline – sequence: 26 givenname: Erik surname: Jansen fullname: Jansen, Erik – sequence: 27 givenname: Harry surname: de Koning fullname: de Koning, Harry – sequence: 28 givenname: Iris surname: Lansdorp – Vogelaar fullname: Lansdorp – Vogelaar, Iris – sequence: 29 givenname: Nicolien surname: van Ravesteyn fullname: van Ravesteyn, Nicolien – sequence: 30 givenname: Nadine surname: Zielonke fullname: Zielonke, Nadine – sequence: 31 givenname: Urska surname: Ivanus fullname: Ivanus, Urska – sequence: 32 givenname: Katja surname: Jarm fullname: Jarm, Katja – sequence: 33 givenname: Dominika Novak surname: Mlakar fullname: Mlakar, Dominika Novak – sequence: 34 givenname: Maja surname: Primic-Žakelj fullname: Primic-Žakelj, Maja – sequence: 35 givenname: Martin surname: McKee fullname: McKee, Martin – sequence: 36 givenname: Jennifer surname: Priaulx fullname: Priaulx, Jennifer |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31932175$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Contributor | Driesprong-de Kok, Inge Lansdorp-Vogelaar, Iris McKee, Martin Priaulx, Jennifer Pitter, Janos Segnan, Nereo de Koning, Harry Ivanus, Urska Senore, Carlo Zielonke, Nadine van Ballegooijen, Marjolein Mlakar, Dominika Novak Primic-Žakelj, Maja Heinävaara, Sirpa Jansen, Erik Veerus, Piret Anttila, Ahti Voko, Zoltan Minozzi, Silvia Jarm, Katja Cañada, Marcell Sarkeala, Tytti Heijnsdijk, Eveline Széles, György van Ravesteyn, Nicolien Gini, Andrea |
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| SubjectTerms | Bias Breast cancer Breast cancer mortality Breast cancer screening Breast Neoplasms - diagnosis Breast Neoplasms - epidemiology Breast Neoplasms - mortality Breast Neoplasms - prevention & control Early Detection of Cancer - methods Early Detection of Cancer - mortality Europe - epidemiology Female Humans Mammography Mammography - methods Mammography - mortality Mortality Mortality - trends Prognosis Reviews Screening Survival Rate Systematic review |
| Title | Evidence for reducing cancer-specific mortality due to screening for breast cancer in Europe: A systematic review |
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