We are analyzing https://link.springer.com/article/10.1186/bcr1354.

Title:
Overdiagnosis and overtreatment of breast cancer: Estimates of overdiagnosis from two trials of mammographic screening for breast cancer | Breast Cancer Research
Description:
Randomised controlled trials have shown that the policy of mammographic screening confers a substantial and significant reduction in breast cancer mortality. This has often been accompanied, however, by an increase in breast cancer incidence, particularly during the early years of a screening programme, which has led to concerns about overdiagnosis, that is to say, the diagnosis of disease that, if left undetected and therefore untreated, would not become symptomatic. We used incidence data from two randomised controlled trials of mammographic screening, the Swedish Two-county Trial and the Gothenburg Trial, to establish the timing and magnitude of any excess incidence of invasive disease and ductal carcinoma in situ (DCIS) in the study groups, to ascertain whether the excess incidence of DCIS reported early in a screening trial is balanced by a later deficit in invasive disease and provide explicit estimates of the rate of
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Keywords {🔍}

screening, overdiagnosis, cancers, incidence, trial, cancer, breast, screen, dcis, study, group, years, control, invasive, tumours, article, excess, rates, trials, time, cases, disease, swedish, gothenburg, overdiagnosed, estimates, twocounty, situ, diagnosed, screens, age, data, groups, results, estimation, google, scholar, interval, mammography, table, figure, pubmed, duffy, randomised, estimate, women, sensitivity, mortality, deficit, size,

Topics {✒️}

uk/bugs/classic/coda04/readme uk/bugs/winbugs/contents full size image homogeneous multi-state model //breast-cancer-research general tumour population randomised controlled trials breast imaging natl cancer inst authors’ original file privacy choices/manage cookies winbugs program updated breast cancer incidence falun central hospital breast cancer screening preclinical screen-detectable period age-specific overdiagnosis rates invasive breast cancer preclinical screen-detectable cancers breast cancer mortality potentially progressive cancer european economic area fitting poisson distributions uniform priors tending radiol clin nth queen mary college uniform annual incidence age-specific incidence progressed represent overdiagnosis maximum likelihood solution long-term effects absolute excesses/deficits author information authors assume exponential incidence expected rate represents provide explicit estimates derive conclusive estimates existing increasing trend expected rates predicted thousand women randomised constant incidence rate fully identify screened absolute incidence rates output analysis software current low level breast screening programme derived formal estimates accepting optional cookies introduction breast cancer

Questions {❓}

Evans AJ, Pinder SE, Ellis IO, Wilson AR: Screen detected ductal carcinoma in situ (DCIS): overdiagnosis or an obligate precursor of invasive disease?
Here, the question of most interest is: how much of the DCIS diagnosed at screening would be expected to progress to invasive cancer if left untreated?
Is DCIS Overrated?
Paci E, Warwick J, Falini P, Duffy SW: Overdiagnosis in service screening: should the increase in breast cancer incidence rates necessarily be a cause for concern?
Smith RA, Duffy SW, Gabe R, Tabar L, Yen AMF, Chen HHT: The randomized trials of breast cancer screening: what have we learned?

Schema {🗺️}

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         headline:Overdiagnosis and overtreatment of breast cancer: Estimates of overdiagnosis from two trials of mammographic screening for breast cancer
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         datePublished:2005-11-10T00:00:00Z
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      headline:Overdiagnosis and overtreatment of breast cancer: Estimates of overdiagnosis from two trials of mammographic screening for breast cancer
      description:Randomised controlled trials have shown that the policy of mammographic screening confers a substantial and significant reduction in breast cancer mortality. This has often been accompanied, however, by an increase in breast cancer incidence, particularly during the early years of a screening programme, which has led to concerns about overdiagnosis, that is to say, the diagnosis of disease that, if left undetected and therefore untreated, would not become symptomatic. We used incidence data from two randomised controlled trials of mammographic screening, the Swedish Two-county Trial and the Gothenburg Trial, to establish the timing and magnitude of any excess incidence of invasive disease and ductal carcinoma in situ (DCIS) in the study groups, to ascertain whether the excess incidence of DCIS reported early in a screening trial is balanced by a later deficit in invasive disease and provide explicit estimates of the rate of 'real' and non-progressive 'overdiagnosed' tumours from the study groups of the trials. We used a multistate model for overdiagnosis and used Markov Chain Monte Carlo methods to estimate the parameters. After taking into account the effect of lead time, we estimated that less than 5% of cases diagnosed at prevalence screen and less than 1% of cases diagnosed at incidence screens are being overdiagnosed. Overall, we estimate overdiagnosis to be around 1% of all cases diagnosed in screened populations. These estimates are, however, subject to considerable uncertainty. Our results suggest that overdiagnosis in mammography screening is a minor phenomenon, but further studies with very large numbers are required for more precise estimation.
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      dateModified:2005-11-10T00:00:00Z
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         Sojourn Time
         Interval Cancer
         Screen Phase
         Excess Incidence
         Prevalence Screen
         Cancer Research
         Oncology
         Surgical Oncology
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      name:Department of Radiology, Center for Breast Imaging, University Hospital of North Norway, Tromsø, Norway
      name:Department of Radiology, Sahlgrenska University Hospital, Göteborg, Sweden
      name:Cancer Research UK Department of Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Queen Mary College, University of London, London, UK
      name:Cancer Research UK Department of Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Queen Mary College, University of London, London, UK

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