@article{995b1c9c595640f0bf6a625fc560ac07,
title = "Modeling the impact of population screening on breast cancer mortality in the United States",
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.",
keywords = "Mammography, Modeling, Screening",
author = "Mandelblatt, {Jeanne S.} and Cronin, {Kathleen A.} and Berry, {Donald A.} and Yaojen Chang and {de Koning}, {Harry J.} and Lee, {Sandra J.} and Plevritis, {Sylvia K.} and Schechter, {Clyde B.} and Stout, {Natasha K.} and {van Ravesteyn}, {Nicolien T.} and Marvin Zelen and Feuer, {Eric J.}",
note = "Funding Information: Grant Support: By NCI cooperative agreement U01 CA152958–01 and NCI Grants RC2CA148577 and U01CA086076. Data collection in the BCSC was supported by NCI-funded BCSC cooperative agreements (U01CA63740, U01CA86076, U01CA86082, U01CA63736, U01CA70013, U01CA69976, U01CA63731, and U01CA70040) and several U.S. state public health departments and cancer registries. CISNET data management and Web site support were provided by Cornerstone Systems Northwest (NCI contract HHSN261200800002C). Funding Information: This work was done under contracts from the Agency for Healthcare Research and Quality (AHRQ) and NCI and grants from the NCI. The NCI provided some data and technical assistance and AHRQ reviewed the manuscript. Model results are the sole responsibility of the investigators.",
year = "2011",
month = oct,
doi = "10.1016/S0960-9776(11)70299-5",
language = "English (US)",
volume = "20",
pages = "S75--S81",
journal = "Breast",
issn = "0960-9776",
publisher = "Churchill Livingstone",
number = "SUPPL. 3",
}