Abstract
Objective: Optimal US screening strategies remain controversial. We use six simulation models to evaluate screening outcomes under varying strategies. Methods: The models incorporate common data on incidence, mammography characteristics, and treatment effects. We evaluate varying initiation and cessation ages applied annually or biennially and calculate mammograms, mortality reduction (vs. no screening), false-positives, unnecessary biopsies and over-diagnosis. Results: The lifetime risk of breast cancer death starting at age 40 is 3% and is reduced by screening. Screening biennially maintains 81% (range 67% to 99%) of annual screening benefits with fewer false-positives. Biennial screening from 50-74 reduces the probability of breast cancer death from 3% to 2.3%. Screening annually from 40 to 84 only lowers mortality an additional one-half of one percent to 1.8% but requires substantially more mammograms and yields more false-positives and over-diagnosed cases. Conclusion: Decisions about screening strategy depend on preferences for benefits vs. potential harms and resource considerations.
| Original language | English (US) |
|---|---|
| Journal | Breast |
| Volume | 20 |
| Issue number | SUPPL. 3 |
| DOIs | |
| State | Published - Oct 2011 |
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Keywords
- Mammography
- Modeling
- Screening
ASJC Scopus subject areas
- Surgery
Cite this
Modeling the impact of population screening on breast cancer mortality in the United States. / Mandelblatt, Jeanne S.; Cronin, Kathleen A.; Berry, Donald A.; Chang, Yaojen; de Koning, Harry J.; Lee, Sandra J.; Plevritis, Sylvia K.; Schechter, Clyde B.; Stout, Natasha K.; van Ravesteyn, Nicolien T.; Zelen, Marvin; Feuer, Eric J.
In: Breast, Vol. 20, No. SUPPL. 3, 10.2011.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Modeling the impact of population screening on breast cancer mortality in the United States
AU - Mandelblatt, Jeanne S.
AU - Cronin, Kathleen A.
AU - Berry, Donald A.
AU - Chang, Yaojen
AU - de Koning, Harry J.
AU - Lee, Sandra J.
AU - Plevritis, Sylvia K.
AU - Schechter, Clyde B.
AU - Stout, Natasha K.
AU - van Ravesteyn, Nicolien T.
AU - Zelen, Marvin
AU - Feuer, Eric J.
PY - 2011/10
Y1 - 2011/10
N2 - Objective: Optimal US screening strategies remain controversial. We use six simulation models to evaluate screening outcomes under varying strategies. Methods: The models incorporate common data on incidence, mammography characteristics, and treatment effects. We evaluate varying initiation and cessation ages applied annually or biennially and calculate mammograms, mortality reduction (vs. no screening), false-positives, unnecessary biopsies and over-diagnosis. Results: The lifetime risk of breast cancer death starting at age 40 is 3% and is reduced by screening. Screening biennially maintains 81% (range 67% to 99%) of annual screening benefits with fewer false-positives. Biennial screening from 50-74 reduces the probability of breast cancer death from 3% to 2.3%. Screening annually from 40 to 84 only lowers mortality an additional one-half of one percent to 1.8% but requires substantially more mammograms and yields more false-positives and over-diagnosed cases. Conclusion: Decisions about screening strategy depend on preferences for benefits vs. potential harms and resource considerations.
AB - Objective: Optimal US screening strategies remain controversial. We use six simulation models to evaluate screening outcomes under varying strategies. Methods: The models incorporate common data on incidence, mammography characteristics, and treatment effects. We evaluate varying initiation and cessation ages applied annually or biennially and calculate mammograms, mortality reduction (vs. no screening), false-positives, unnecessary biopsies and over-diagnosis. Results: The lifetime risk of breast cancer death starting at age 40 is 3% and is reduced by screening. Screening biennially maintains 81% (range 67% to 99%) of annual screening benefits with fewer false-positives. Biennial screening from 50-74 reduces the probability of breast cancer death from 3% to 2.3%. Screening annually from 40 to 84 only lowers mortality an additional one-half of one percent to 1.8% but requires substantially more mammograms and yields more false-positives and over-diagnosed cases. Conclusion: Decisions about screening strategy depend on preferences for benefits vs. potential harms and resource considerations.
KW - Mammography
KW - Modeling
KW - Screening
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UR - http://www.scopus.com/inward/citedby.url?scp=80054872085&partnerID=8YFLogxK
U2 - 10.1016/S0960-9776(11)70299-5
DO - 10.1016/S0960-9776(11)70299-5
M3 - Article
VL - 20
JO - Breast
JF - Breast
SN - 0960-9776
IS - SUPPL. 3
ER -