Modeling the impact of population screening on breast cancer mortality in the United States

Jeanne S. Mandelblatt, Kathleen A. Cronin, Donald A. Berry, Yaojen Chang, Harry J. de Koning, Sandra J. Lee, Sylvia K. Plevritis, Clyde B. Schechter, Natasha K. Stout, Nicolien T. van Ravesteyn, Marvin Zelen, Eric J. Feuer

Research output: Contribution to journalArticle

17 Citations (Scopus)

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 languageEnglish (US)
JournalBreast
Volume20
Issue numberSUPPL. 3
DOIs
StatePublished - Oct 2011

Fingerprint

Breast Neoplasms
Mortality
Mammography
Population
Biopsy
Incidence
Breast Cancer 3

Keywords

  • Mammography
  • Modeling
  • Screening

ASJC Scopus subject areas

  • Surgery

Cite this

Mandelblatt, J. S., Cronin, K. A., Berry, D. A., Chang, Y., de Koning, H. J., Lee, S. J., ... Feuer, E. J. (2011). Modeling the impact of population screening on breast cancer mortality in the United States. Breast, 20(SUPPL. 3). https://doi.org/10.1016/S0960-9776(11)70299-5

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 journalArticle

Mandelblatt, JS, Cronin, KA, Berry, DA, Chang, Y, de Koning, HJ, Lee, SJ, Plevritis, SK, Schechter, CB, Stout, NK, van Ravesteyn, NT, Zelen, M & Feuer, EJ 2011, 'Modeling the impact of population screening on breast cancer mortality in the United States', Breast, vol. 20, no. SUPPL. 3. https://doi.org/10.1016/S0960-9776(11)70299-5
Mandelblatt JS, Cronin KA, Berry DA, Chang Y, de Koning HJ, Lee SJ et al. Modeling the impact of population screening on breast cancer mortality in the United States. Breast. 2011 Oct;20(SUPPL. 3). https://doi.org/10.1016/S0960-9776(11)70299-5
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. / Modeling the impact of population screening on breast cancer mortality in the United States. In: Breast. 2011 ; Vol. 20, No. SUPPL. 3.
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