Review
. 2011 Jan 19:(1):CD001877. doi: 10.1002/14651858.CD001877.pub4. Screening for breast cancer with mammographyAffiliations
AffiliationItem in Clipboard
Review
Screening for breast cancer with mammographyPeter C Gøtzsche et al. Cochrane Database Syst Rev. 2011.
. 2011 Jan 19:(1):CD001877. doi: 10.1002/14651858.CD001877.pub4. AffiliationItem in Clipboard
Update inGøtzsche PC, Jørgensen KJ. Gøtzsche PC, et al. Cochrane Database Syst Rev. 2013 Jun 4;2013(6):CD001877. doi: 10.1002/14651858.CD001877.pub5. Cochrane Database Syst Rev. 2013. PMID: 23737396 Free PMC article. Review.
Background: A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary.
Objectives: To assess the effect of screening for breast cancer with mammography on mortality and morbidity.
Search strategy: We searched PubMed (November 2008).
Selection criteria: Randomised trials comparing mammographic screening with no mammographic screening.
Data collection and analysis: Both authors independently extracted data. Study authors were contacted for additional information.
Main results: Eight eligible trials were identified. We excluded a biased trial and included 600,000 women in the analyses. Three trials with adequate randomisation did not show a significant reduction in breast cancer mortality at 13 years (relative risk (RR) 0.90, 95% confidence interval (CI) 0.79 to 1.02); four trials with suboptimal randomisation showed a significant reduction in breast cancer mortality with an RR of 0.75 (95% CI 0.67 to 0.83). The RR for all seven trials combined was 0.81 (95% CI 0.74 to 0.87). We found that breast cancer mortality was an unreliable outcome that was biased in favour of screening, mainly because of differential misclassification of cause of death. The trials with adequate randomisation did not find an effect of screening on cancer mortality, including breast cancer, after 10 years (RR 1.02, 95% CI 0.95 to 1.10) or on all-cause mortality after 13 years (RR 0.99, 95% CI 0.95 to 1.03).Numbers of lumpectomies and mastectomies were significantly larger in the screened groups (RR 1.31, 95% CI 1.22 to 1.42) for the two adequately randomised trials that measured this outcome; the use of radiotherapy was similarly increased.
Authors' conclusions: Screening is likely to reduce breast cancer mortality. As the effect was lowest in the adequately randomised trials, a reasonable estimate is a 15% reduction corresponding to an absolute risk reduction of 0.05%. Screening led to 30% overdiagnosis and overtreatment, or an absolute risk increase of 0.5%. This means that for every 2000 women invited for screening throughout 10 years, one will have her life prolonged and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily. Furthermore, more than 200 women will experience important psychological distress for many months because of false positive findings. It is thus not clear whether screening does more good than harm. To help ensure that the women are fully informed of both benefits and harms before they decide whether or not to attend screening, we have written an evidence-based leaflet for lay people that is available in several languages on www.cochrane.dk.
Update ofGøtzsche PC, Jørgensen KJ. Gøtzsche PC, et al. Cochrane Database Syst Rev. 2013 Jun 4;2013(6):CD001877. doi: 10.1002/14651858.CD001877.pub5. Cochrane Database Syst Rev. 2013. PMID: 23737396 Free PMC article. Review.
Myers ER, Moorman P, Gierisch JM, Havrilesky LJ, Grimm LJ, Ghate S, Davidson B, Mongtomery RC, Crowley MJ, McCrory DC, Kendrick A, Sanders GD. Myers ER, et al. JAMA. 2015 Oct 20;314(15):1615-34. doi: 10.1001/jama.2015.13183. JAMA. 2015. PMID: 26501537 Review.
Etzioni R, Gulati R, Mallinger L, Mandelblatt J. Etzioni R, et al. Ann Intern Med. 2013 Jun 4;158(11):831-8. doi: 10.7326/0003-4819-158-11-201306040-00008. Ann Intern Med. 2013. PMID: 23732716 Free PMC article. Review.
Forbes LJ, Ramirez AJ. Forbes LJ, et al. Curr Oncol Rep. 2014 May;16(5):382. doi: 10.1007/s11912-014-0382-4. Curr Oncol Rep. 2014. PMID: 24595678 Review.
Hagerling C, Owyong M, Sitarama V, Wang CY, Lin C, van den Bijgaart RJE, Koopman CD, Brenot A, Nanjaraj A, Wärnberg F, Jirström K, Klein OD, Werb Z, Plaks V. Hagerling C, et al. BMC Cancer. 2020 Jun 10;20(1):542. doi: 10.1186/s12885-020-06986-z. BMC Cancer. 2020. PMID: 32522170 Free PMC article.
Eiro N, Cid S, Aguado N, Fraile M, de Pablo N, Fernández B, Domínguez F, González LO, Vizoso FJ. Eiro N, et al. Int J Mol Sci. 2020 Dec 31;22(1):371. doi: 10.3390/ijms22010371. Int J Mol Sci. 2020. PMID: 33396463 Free PMC article.
Elder K, Coles C, Dodwell D, Elsberger B, Foster J, Gaunt C, Henderson JR, Lyburn I, Mabena C, Morgan J, Nabi Z, Paramasivan S, Pinder S, Pirrie S, Potter S, Roberts T, Sharma N, Southgate E, Stobart H, Talwalkar A, Taylor-Phillips S, Teh W, Turner E, Wallis MG, Rea D, McIntosh S. Elder K, et al. BMJ Open. 2025 Apr 8;15(4):e099702. doi: 10.1136/bmjopen-2025-099702. BMJ Open. 2025. PMID: 40204306 Free PMC article.
RetroSearch is an open source project built by @garambo | Open a GitHub Issue
Search and Browse the WWW like it's 1997 | Search results from DuckDuckGo
HTML:
3.2
| Encoding:
UTF-8
| Version:
0.7.3