Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

For many, mammography every other year has benefits of annual screening, but less harm

17.11.2009
Conclusion represents unanimous consensus of 6 independent research groups from various academic institutions

A comprehensive analysis of various mammography screening schedules suggests that biennial (every two years) screening of average risk women between the ages of 50 and 74 achieves most of the benefits of annual screening, but with less harm. The results represent a unanimous consensus of six independent research groups from various academic institutions. Their findings are published in the November 17, 2009 Annals of Internal Medicine.

Researchers from CISNET, the NCI-funded Cancer Intervention and Surveillance Modeling Network, used independent models to examine 20 screening strategies with different starting and stopping ages and intervals. Modeling estimates the lifetime impact (outcomes including benefits and harms) of breast cancer screening mammography. The CISNET models link known data across the course of life and include national data on age-specific breast cancer incidence, mortality, mammography characteristics and treatment effects.

"It's reassuring that all CISNET modeling groups came to the same conclusion even when applying different models to these data," says the paper's lead author, Jeanne S. Mandelblatt, MD, MPH, of Georgetown Lombardi Comprehensive Cancer Center, a CISNET member. "While the findings represent a comprehensive review of existing data, decisions about the best screening strategy depend on individual and public health goals, resources, and tolerance for false-positive mammograms, unnecessary biopsies and over-diagnosis."

The CISNET analysis shows that screening every other year maintains almost all of the benefit (an average of 81 percent) of annual screening with almost half the number of false-positives. Compared with no screening, mammography screening every other year from ages 50 to 69 achieves a median reduction in breast cancer mortality of 16.5 percent over a life time. If screening is started at age 40 versus 50 and performed every other year, there is a median mortality reduction of 19.5 percent (an additional 1 woman per 1000), but an increase in false-positives, unnecessary biopsies, and anxiety.

"False-positives" represent mammograms read as abnormal that often require further follow-up in women who are found to not have cancer. An "unnecessary biopsy" occurs after a false positive mammogram when the biopsy is normal. "Over-diagnosis" is the detection of a cancer through screening that otherwise never would have produced symptoms or affected the woman's health. Since usually it is not possible to determine which cancers will progress, almost all cancers detected during screening are treated.

Mandelblatt says the benefits of biennial screening are consistent with what is known about the breast cancer's biology. In the majority of women, most tumors are slow growing and this proportion increases with age, so that there is little loss in survival benefit across the population for screening every year versus every other year. For women with aggressive, faster growing tumors, annual screening is not likely to make a difference in survival. For these women, different approaches may be needed and is an important area of on-going research.

While the model results confirmed that mammography saves lives, Mandelblatt explains that there are smaller overall benefits from starting screening earlier than age 50 because few women develop breast cancer in the younger age groups, and screening younger women is accompanied by a large number of false-positive mammograms. "This can lead to stress for women and unnecessary biopsies. We need more research to understand how to tailor screening by individual risk," she says.

"These modeling data represent an average finding regarding the population of women so it can't be emphasized enough that women need to talk to their health care provider for a screening program that is best for them," Mandelblatt concludes.

The CISNET analysis was one of many sources of evidence that the U.S. Preventive Services Task Force (an independent scientific panel convened by the Agency for Healthcare Research and Quality) relied upon in developing the new mammography screening guidelines announced today.

The CISNET study was supported by funding from the National Cancer Institute. The authors report no potential financial conflicts.

In addition to Mandelblatt, authors include: Kathy Cronin and Eric Feuer of the National Cancer Institute; Donald Berry, Mark Munsell, Peter Ravdin and John Venier of the University of Texas MD Anderson Cancer Center; Harry J. de Koning, Gerrit Draisma and Nicolien van Ravesteyn of the Department of Public Health, Rotterdam, the Netherlands; Hui Huang of the Dana-Farber Cancer Institute; Sandra Lee and Marvin Zelen are in the Dana-Farber Cancer Institute and Harvard School of Public Health; Sylvia Plevritis, Bronislava Sigal and Stephanie Bailey of Stanford University; Clyde Schechter of the Albert Einstein College of Medicine; Michael Stoto of Georgetown University Medical Center; Natasha Stout of Harvard Medical School and Harvard Pilgrim Health Care.

About Lombardi Comprehensive Cancer Center

The Lombardi Comprehensive Cancer Center, part of Georgetown University Medical Center and Georgetown University Hospital, seeks to improve the diagnosis, treatment, and prevention of cancer through innovative basic and clinical research, patient care, community education and outreach, and the training of cancer specialists of the future. Lombardi is one of only 41 comprehensive cancer centers in the nation, as designated by the National Cancer Institute, and the only one in the Washington, DC, area. For more information, go to http://lombardi.georgetown.edu.

About Georgetown University Medical Center

Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through Georgetown's affiliation with MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO), home to 60 percent of the university's sponsored research funding.

National Cancer Institute

NCI leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. More information about cancer, screening, and prevention is available on the NCI Web site at http://www.cancer.gov or from NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

Karen Mallet | EurekAlert!
Further information:
http://www.georgetown.edu
http://www.cancer.gov

More articles from Health and Medicine:

nachricht New malaria analysis method reveals disease severity in minutes
14.08.2017 | University of British Columbia

nachricht New type of blood cells work as indicators of autoimmunity
14.08.2017 | Instituto de Medicina Molecular

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

Gold shines through properties of nano biosensors

17.08.2017 | Physics and Astronomy

Greenland ice flow likely to speed up: New data assert glaciers move over sediment, which gets more slippery as it gets wetter

17.08.2017 | Earth Sciences

Mars 2020 mission to use smart methods to seek signs of past life

17.08.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>