Screening: Assessment of current studies
CancerPublished 1 January 1994Open access
Sam Shapiro
Citations116
SJR quartileQ1
SJR score2.95
SNIP1.90
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TL;DR
This work concludes that routine mass screening programs with mammography should cover women aged 40–49, and that results of studies on this question are affected by differences in design, adequacy of sample size, quality of mammography, period of follow‐up, and other methodologic and content issues.
Abstract
Public health policy on mass screening with mammography for women aged 40-49 is questionable. At this time, the emphasis should be on physicians advising women about the uncertainty of the benefits of routine mammography when referrals are being considered.
Keywords
Medicine
The LancetBreast cancer screening with mammography: overview of Swedish randomised trials
978 Citations1993L. Nyström, Stig Wall +10 more
There was a consistent risk reduction associated with screening in all studies, although the point estimate of the relative risk for all ages varied non-significantly between 0.68 and 0.84.
BMJMammographic screening and mortality from breast cancer: the Malmö mammographic screening trial.
926 Citations1988Ingvar Andersson, Knut Aspegren +7 more
JNCI Journal of the National Cancer InstituteReport of the International Workshop on Screening for Breast Cancer
799 Citations1993Suzanne W. Fletcher, William C. Black +3 more
PubMedCanadian National Breast Screening Study: 1. Breast cancer detection and death rates among women aged 40 to 49 years.
754 Citations1992Anthony B. Miller, Cornelia J. Baines +2 more
Screening with yearly mammography and physical examination of the breasts detected considerably more node-negative, small tumours than usual care, but it had no impact on the rate of death from breast cancer up to 7 years' follow-up from entry.
The LancetEdinburgh trial of screening for breast cancer: mortality at seven years
450 Citations1990Alison Huggins
Between 1979 and 1981, 45,130 women in Edinburgh aged 45-64 were entered into a randomised trial of breast cancer screening by mammography and clinical examination, which showed a mortality reduction of 17% in women aged 50 years and over.
The LancetEVALUATION OF SCREENING FOR BREAST CANCER IN A NON-RANDOMISED STUDY (THE DOM PROJECT) BY MEANS OF A CASE-CONTROL STUDY
377 Citations1984H.J.A. Collette, Jan J. Rombach +2 more
In 1974 a non-randomised study of the effect of mass screening by physical examination and xeromammography on mortality from breast cancer was started, and of the 20 555 eligible women in the city of Utrecht born between 1911 and 1925, 14 796 attended for screening.
Journal of Epidemiology & Community HealthThe Swedish two county trial of mammographic screening for breast cancer: recent results and calculation of benefit.
362 Citations1989Làszló Tabár, G Fagerberg +2 more
Results show an increasingly significant deficit in deaths from breast cancer among the 77,092 women invited to screening relative to the 56,000 not invited, with no significant difference between the effects of screening in the two counties, and results remain the same when adjusted for age.
JNCI Journal of the National Cancer InstituteAnalysis of Breast Cancer Mortality and Stage Distribution by Age for the Health Insurance Plan Clinical Trial
304 Citations1988K. C. Chu, Charles R. Smart +1 more
The reduced breast cancer mortality in the study group appears to result from lower mortality in stage I cases as well as from earlier case detection, and this may explain differences between the two age-at-entry cohorts in the length of follow-up time required to demonstrate a mortality reduction due to screening.
Breast Cancer Research and TreatmentRandomized study of mammography screening — preliminary report on mortality in the stockholm trial
262 Citations1991Jan Frisell, Gunnar Eklund +4 more
A randomized trial of breast cancer screening by single-view mammography alone versus no intervention in a control group of 20,000 women and the estimate of mortality reduction lies between the results from two earlier Swedish randomized controlled trials.
International Journal of CancerA case‐control study of the efficacy of a non‐randomized breast cancer screening program in florence (Italy)
196 Citations1986Domenico Palli, Marco Rosselli Del Turco +5 more
In a rural area near Florence a population‐based screening program for breast cancer was started in 1970, offering a mammography test every 2.5 years to all women between 40 and 70 years of age, a case‐control study has been carried out comparing the screening history of all women who died from breast cancer in this area in the years 1977–1984 with that of a matched group of living controls.
PubMedThe effectiveness of breast cancer screening by mammography in younger women.
142 Citations1993Mark Elwood, Brian Cox +1 more
This evidence provides no basis for the promotion of mammographic screening in women under age 50 in the general population, and appropriate information including the fact that there has been no demonstrated ultimate benefit should be given.
JNCI Journal of the National Cancer InstituteBreast Cancer Incidence and Mortality in the Breast Cancer Detection Demonstration Project
140 Citations1988Andra Morrison, Jade Brisson +1 more
Breast cancer incidence and mortality were lower for women who entered the BCDDP for routine screening than they were forWomen who entered for a reason such as concern about breast disease, family history of breast cancer, or a physician's recommendation.
American Journal of RoentgenologyCanadian National Breast Screening Study: assessment of technical quality by external review.
125 Citations1990Cornelia J. Baines, Anthony B. Miller +6 more
A retrospective review of NBSS mammography by three external reviewers confirmed that technical quality improved from 1980 to 1987, and was associated with improved technology (film, processing, and units) and with the quality assurance programs operating during the NBSs, which identified problems and offered remedies.
JNCI Journal of the National Cancer InstituteBreast Cancer Incidence and Mortality in the Breast Cancer Detection Demonstration
88 Citations1989Morrison
American Journal of RoentgenologyThe Canadian Screening Program: A Different Perspective
65 Citations1990Daniel B. Kopans
Journal of Epidemiology & Community HealthRandomisation by cluster and the problem of social class bias.
46 Citations1989FE Alexander, M M Roberts +2 more
It is found that spurious mortality differences were present in the analyses, which do not allow for socio-economic status, and it is recommended that for future studies with outcome related to socio-Economic status, randomisations which use this design be stratified by socio- economic criteria where this is feasible.
The BreastBreast cancer mortality after 10 years in the UK Trial of Early Detection of Breast Cancer
39 Citations1993
CancerPeriodic breast cancer screening in seven foreign countries
33 Citations1992Sam Shapiro
These results show a consistent picture of benefits of screening at 50 years of age and older; the international evidence for younger women is less clear.