Breast cancer screening: A summary of the evidence for the U.S. Preventive Services Task Force

Linda Humphrey, Mark Helfand, Benjamin K S Chan, Steven H. Woolf

Research output: Contribution to journalArticle

932 Citations (Scopus)

Abstract

Purpose: To synthesize new data on breast cancer screening for the U.S. Preventive Services Task Force. Data Sources: MEDLINE; the Cochrane Controlled Trials Registry; and reference lists of reviews, editorials, and original studies. Study Selection: Eight randomized, controlled trials of mammography and 2 trials evaluating breast self-examination were included. One hundred fifty-four publications of the results of these trials, as well as selected articles about the test characteristics and harms associated with screening, were examined. Data Extraction: Predefined criteria were used to assess the quality of each study. Meta-analyses using a Bayesian random-effects model were conducted to provide summary relative risk estimates and credible intervals (Crls) for the effectiveness of screening with mammography in reducing death from breast cancer. Data Synthesis: For studies of fair quality or better, the summary relative risk was 0.84 (95% Crl, 0.77 to 0.91) and the number needed to screen to prevent one death from breast cancer after approximately 14 years of observation was 1224 (Crl, 665 to 2564). Among women younger than 50 years of age, the summary relative risk associated with mammography was 0.85 (Crl, 0.73 to 0.99) and the number needed to screen to prevent one death from breast cancer after 14 years of observation was 1792 (Crl, 764 to 10 540). For clinical breast examination and breast self-examination, evidence from randomized trials is inconclusive. Conclusions: In the randomized, controlled trials, mammography reduced breast cancer mortality rates among women 40 to 74 years of age. Greater absolute risk reduction was seen among older women. Because these results incorporate several rounds of screening, the actual number of mammograms needed to prevent one death from breast cancer is higher. In addition, each screening has associated risks and costs.

Original languageEnglish (US)
Pages (from-to)347-360
Number of pages14
JournalAnnals of Internal Medicine
Volume137
Issue number5 I
StatePublished - Sep 3 2002
Externally publishedYes

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Advisory Committees
Early Detection of Cancer
Mammography
Breast Neoplasms
Breast Self-Examination
Randomized Controlled Trials
Observation
Numbers Needed To Treat
Information Storage and Retrieval
MEDLINE
Registries
Publications
Meta-Analysis
Breast
Costs and Cost Analysis
Mortality

ASJC Scopus subject areas

  • Medicine(all)

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Breast cancer screening : A summary of the evidence for the U.S. Preventive Services Task Force. / Humphrey, Linda; Helfand, Mark; Chan, Benjamin K S; Woolf, Steven H.

In: Annals of Internal Medicine, Vol. 137, No. 5 I, 03.09.2002, p. 347-360.

Research output: Contribution to journalArticle

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