Benefits and harms of mammography screening

Mammography screening for breast cancer is widely available in many countries. Initially praised as a universal achievement to improve women's health and to reduce the burden of breast cancer, the benefits and harms of mammography screening have been debated heatedly in the past years. This rev...

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Veröffentlicht in:Breast cancer research : BCR Jg. 17; H. 1; S. 63
Hauptverfasser: Løberg, Magnus, Lousdal, Mette Lise, Bretthauer, Michael, Kalager, Mette
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 01.05.2015
BioMed Central Ltd
Schlagworte:
Analysis
Biomedical and Life Sciences
Biomedicine
Breast Neoplasms - diagnosis
Breast Neoplasms - epidemiology
Breast Neoplasms - mortality
Cancer
Cancer Research
Carcinoma, Ductal
Complications and side effects
Diagnosis
Early Detection of Cancer - adverse effects
Early Detection of Cancer - methods
Female
Health aspects
Humans
Mammography
Mammography - adverse effects
Mammography - methods
Mass Screening
Mortality
Oncology
Review
Sensitivity and Specificity
Surgical Oncology
Women
United Kingdom
Mammography Screening
Breast Cancer Mortality
Invasive Breast Cancer
Breast Cancer
Digital Mammography
ISSN:1465-542X, 1465-5411, 1465-542X
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Zusammenfassung:Mammography screening for breast cancer is widely available in many countries. Initially praised as a universal achievement to improve women's health and to reduce the burden of breast cancer, the benefits and harms of mammography screening have been debated heatedly in the past years. This review discusses the benefits and harms of mammography screening in light of findings from randomized trials and from more recent observational studies performed in the era of modern diagnostics and treatment. The main benefit of mammography screening is reduction of breast-cancer related death. Relative reductions vary from about 15 to 25% in randomized trials to more recent estimates of 13 to 17% in meta-analyses of observational studies. Using UK population data of 2007, for 1,000 women invited to biennial mammography screening for 20 years from age 50, 2 to 3 women are prevented from dying of breast cancer. All-cause mortality is unchanged. Overdiagnosis of breast cancer is the main harm of mammography screening. Based on recent estimates from the United States, the relative amount of overdiagnosis (including ductal carcinoma in situ and invasive cancer) is 31%. This results in 15 women overdiagnosed for every 1,000 women invited to biennial mammography screening for 20 years from age 50. Women should be unpassionately informed about the benefits and harms of mammography screening using absolute effect sizes in a comprehensible fashion. In an era of limited health care resources, screening services need to be scrutinized and compared with each other with regard to effectiveness, cost-effectiveness and harms.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
content type line 23
ISSN:1465-542X
1465-5411
1465-542X
DOI:10.1186/s13058-015-0525-z