The evidence base for breast cancer screeningPreventive Medicine
Date of this Version9-1-2011
Document TypeJournal Article
AbstractThe history of breast cancer screening is littered with controversy. With 10 trials spanning 4 decades, we have a substantial body of evidence, but with different aims and flaws. Combined analysis of the intention-to-treat results gives an overall relative reduction in breast cancer mortality of 19% (95% CI 12%-26%), which, if adjusted for non-attendance gives an approximate 25% relative reduction for those who attend screening. However, given that 4% of all-cause mortality is due to breast cancer deaths, this translates into a less than 1% reduction in all-cause mortality. An emerging issue in interpretation is the improvements in treatment since these trials recruited women. Modern systemic therapy would have improved survival (models suggest between 12% and 21%) in both screened and non-screened groups, which would result in a lesser difference in. absolute risk reduction from screening but probably a similar, or slightly smaller, relative risk reduction. However benefits and harms, particularly over-diagnosis, need to balanced and differ by age-groups. The informed views of recipients of screening are needed to guide current and future policy on screening.
Citation InformationPaul P. Glasziou and Nehmet Houssami. "The evidence base for breast cancer screening" Preventive Medicine Vol. 53 Iss. 3 (2011) p. 100 - 102 ISSN: 0091-7435
Available at: http://works.bepress.com/paul_glasziou/60/