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Title:
Why mammography screening has not lived up to expectations from the randomised trials | Cancer Causes & Control
Description:
We analysed the relation between tumour sizes and stages and the reported effects on breast cancer mortality with and without screening in trials and observational studies. The average tumour sizes in all the trials suggest only a 12% reduction in breast cancer mortality, which agrees with the 10% reported in the most reliable trials. Recent studies of tumour sizes and tumour stages show that screening has not lowered the rate of advanced cancers. In agreement with this, recent observational studies of breast cancer mortality have failed to find an effect of screening. In contrast, screening leads to serious harms in healthy women through overdiagnosis with subsequent overtreatment and false-positive mammograms. We suggest that the rationale for breast screening be urgently reassessed by policy-makers. The observed decline in breast cancer mortality in many countries seems to be caused by improved adjuvant therapy and breast cancer awareness, not screening. We also believe it is more important to reduce the incidence of cancer than to detect it ‘early.’ Avoiding getting screening mammograms reduces the risk of becoming a breast cancer patient by one-third.
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Keywords {🔍}
cancer, breast, screening, google, scholar, article, pubmed, mammography, cas, mortality, gøtzsche, med, trials, overdiagnosis, lancet, mammographic, zahl, jørgensen, health, tumour, incidence, bmj, oncol, trial, tabar, swedish, duffy, privacy, cookies, content, data, randomised, mæhlen, effect, access, rates, study, author, fagerberg, results, analysis, information, publish, search, control, review, peter, cancers, women, mammograms,
Topics {✒️}
karsten juhl jørgensen month download article/chapter population-based screening-program view mammographic screening lymph node status uk/anz dcis trial pre-mammography screening period average tumour sizes early breast cancer tumour stages show full article pdf privacy choices/manage cookies breast cancer mortality breast-cancer mortality author information authors breast cancer screening keyword breast cancer awareness breast cancer patient invasive breast cancer breast cancer atypia breast cancer diagnosed spotting breast cancer organised mammography screening tumour sizes tumor size screening mammograms reduces breast cancer patients tumour development hampshire mammography network article cancer interval breast carcinomas related subjects medical decision making brystkreftdødelighet og validititet ullevål university hospital nordic cochrane centre false-positive mammograms breast cancers detected european economic area cancer rates decline check access similar access instant access conditions privacy policy human malignant tumors swedish national board randomized screening trial article gøtzsche mammographic screening justifiable
Questions {❓}
- Gøtzsche PC, Olsen O (2000) Is screening for breast cancer with mammography justifiable?
- Jørgensen KJ, Keen JD, Gøtzsche PC (2011) Is mammographic screening justifiable considering its substantial overdiagnosis rate and minor effect on mortality?
- Paci E, Warwick J, Falini P, Duffy SW (2004) Overdiagnosis in screening: is the increase in breast cancer incidence rates a cause for concern?
- Rostgaard K, Vaeth M, Rootzén H, Lynge E (2010) Why did the breast cancer lymph node status distribution improve in Denmark in the pre-mammography screening period of 1978–1994?
- Smith RA, Duffy SW, Gabe R et al (2004) The randomized trials of breast cancer screening: what have we learned?
- By the year 2015?
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headline:Why mammography screening has not lived up to expectations from the randomised trials
description:We analysed the relation between tumour sizes and stages and the reported effects on breast cancer mortality with and without screening in trials and observational studies. The average tumour sizes in all the trials suggest only a 12% reduction in breast cancer mortality, which agrees with the 10% reported in the most reliable trials. Recent studies of tumour sizes and tumour stages show that screening has not lowered the rate of advanced cancers. In agreement with this, recent observational studies of breast cancer mortality have failed to find an effect of screening. In contrast, screening leads to serious harms in healthy women through overdiagnosis with subsequent overtreatment and false-positive mammograms. We suggest that the rationale for breast screening be urgently reassessed by policy-makers. The observed decline in breast cancer mortality in many countries seems to be caused by improved adjuvant therapy and breast cancer awareness, not screening. We also believe it is more important to reduce the incidence of cancer than to detect it ‘early.’ Avoiding getting screening mammograms reduces the risk of becoming a breast cancer patient by one-third.
datePublished:2011-11-10T00:00:00Z
dateModified:2011-11-10T00:00:00Z
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pageEnd:21
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Tumour size
Tumour stage
Mammography screening
Overdiagnosis
Breast cancer mortality
Cancer Research
Biomedicine
general
Oncology
Public Health
Epidemiology
Hematology
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description:We analysed the relation between tumour sizes and stages and the reported effects on breast cancer mortality with and without screening in trials and observational studies. The average tumour sizes in all the trials suggest only a 12% reduction in breast cancer mortality, which agrees with the 10% reported in the most reliable trials. Recent studies of tumour sizes and tumour stages show that screening has not lowered the rate of advanced cancers. In agreement with this, recent observational studies of breast cancer mortality have failed to find an effect of screening. In contrast, screening leads to serious harms in healthy women through overdiagnosis with subsequent overtreatment and false-positive mammograms. We suggest that the rationale for breast screening be urgently reassessed by policy-makers. The observed decline in breast cancer mortality in many countries seems to be caused by improved adjuvant therapy and breast cancer awareness, not screening. We also believe it is more important to reduce the incidence of cancer than to detect it ‘early.’ Avoiding getting screening mammograms reduces the risk of becoming a breast cancer patient by one-third.
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dateModified:2011-11-10T00:00:00Z
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Tumour size
Tumour stage
Mammography screening
Overdiagnosis
Breast cancer mortality
Cancer Research
Biomedicine
general
Oncology
Public Health
Epidemiology
Hematology
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