scholarly journals Some current issues in breast cancer screening

2005 ◽  
Vol 12 (3) ◽  
pp. 128-133 ◽  
Author(s):  
Stephen W Duffy
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Natural History ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Randomized Trials ◽  
Mammographic Screening ◽  
Research Setting ◽  
Number Needed To Screen ◽  
Absolute Benefit

Randomized trials of mammography have demonstrated the efficacy of mammographic screening for breast cancer in terms of preventing deaths, but various issues of particular interest remain, including: • quantification of overdiagnosis; • evaluation of service screening outside the research setting; • absolute benefit in terms of number needed to screen per life saved; • which types of tumours benefit most from early detection; • use of screening data to investigate tumour biology and natural history. This paper describes examples of approaches to the above issues, along with some important results.

scholarly journals Lower attendance rates in immigrant versus non-immigrant women in the Norwegian Breast Cancer Screening Programme

2017 ◽  
Vol 25 (3) ◽  
pp. 155-161 ◽  
Author(s):  
Sameer Bhargava ◽  
Kaitlyn Tsuruda ◽  
Kåre Moen ◽  
Ida Bukholm ◽  
Solveig Hofvind
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Programme ◽  
Immigrant Women ◽  
Population Based ◽  
Mammographic Screening ◽  
Attendance Rates ◽  
Breast Cancer Screening Programme ◽  
Cancer Screening Programme

Objective The Norwegian Breast Cancer Screening Programme invites women aged 50–69 to biennial mammographic screening. Although 84% of invited women have attended at least once, attendance rates vary across the country. We investigated attendance rates among various immigrant groups compared with non-immigrants in the programme. Methods There were 4,053,691 invitations sent to 885,979 women between 1996 and 2015. Using individual level population-based data from the Cancer Registry and Statistics Norway, we examined percent attendance and calculated incidence rate ratios, comparing immigrants with non-immigrants, using Poisson regression, following women's first invitation to the programme and for ever having attended. Results Immigrant women had lower attendance rates than the rest of the population, both following the first invitation (53.1% versus 76.1%) and for ever having attended (66.9% versus 86.4%). Differences in attendance rates between non-immigrant and immigrant women were less pronounced, but still present, when adjusted for sociodemographic factors. We also identified differences in attendance between immigrant groups. Attendance increased with duration of residency in Norway. A subgroup analysis of migrants' daughters showed that 70.0% attended following the first invitation, while 82.3% had ever attended. Conclusions Immigrant women had lower breast cancer screening attendance rates. The rationale for immigrant women's non-attendance needs to be explored through further studies targeting women from various birth countries and regions.

scholarly journals A limited review of over diagnosis methods and long-term effects in breast cancer screening

2011 ◽  
pp. 143-147
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Critical Issue ◽  
Long Term Effects ◽  
Screening Programs ◽  
Probability Modeling

Breast cancer screening programs have been effective in detecting tumors prior to symptoms. Recently, there has been concern over the issue of over-diagnosis, that is, diagnosis of a breast cancer that does not manifest prior to death. Estimates for over-diagnosis vary, ranging from 7 to 52%. This variability may be due partially to issues associated with bias and/or incorrect inferences associated with the lack of probability modeling. A critical issue is how to evaluate the long-term effects due to continued screening. Participants in a periodic screening program can be classified into four mutually exclusive groups depending on whether individuals are diagnosed and whether their symptoms appear prior to death: True-earlydetection; No-early-detection; Over-diagnosis; and Not-sonecessary. All initially superficially healthy people will eventually fall into one of these four categories. This manuscript reviews the major methodologies associated with the over-diagnosis and long-term effects of breast cancer screening.

scholarly journals Self-perceived Risk of Breast Cancer and Screening Behaviors of First-degree Female Relatives of Breast Cancer Patients at the Uganda Cancer Institute, Uganda

2021 ◽  
Author(s):  
Provia Ainembabazi ◽  
Derrick Bary Abila ◽  
Grace Manyangwa ◽  
Godwin Anguzu ◽  
Innocent Mutyaba ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Cancer Patients ◽  
Breast Cancer Screening ◽  
Perceived Risk ◽  
Breast Cancer Patients ◽  
Perceived Risks ◽  
First Degree Relatives ◽  
Cancer Breast

Abstract Introduction In Uganda, Breast cancer is the most common cancer in females globally. The majority of the patients present with advanced-stage disease at diagnoses and experience high mortality. This underscores the importance of early detection approaches based on awareness of risk factors and self-perceived risks, and symptoms of the disease to promote adoption of risk reduction behaviors and prompt health-seeking respectively. This study assessed the self-perceived risk of breast cancer, and breast cancer screening behaviours among first-degree female relatives of breast cancer patients in Uganda.Methods This was a cross-sectional study employing quantitative approaches for data collection and analyses. First-degree female relatives of patients attending care at Uganda Cancer Institute were recruited consecutively in the study. A pre-tested coded questionnaire was used to collect data on self-perceived risks, breast cancer risks, and breast cancer screening behaviours. Data were collected between March to October 2019. A modified Poisson regression model was used to evaluate factors associated with self-perceived risk of breast cancer and breast cancer risk awareness.ResultsWe enrolled 296 first-degree female relatives from 197 female breast cancer patients. The median age (IQR) was 33 (26-43) years. A majority (60.1%, 178/296) of the participants had a low self-perceived risk of breast cancer. Breast self-examination (55.7%, 165/296) was the most practiced screening method followed by clinical breast examination (n= 64/296, 21.6%), ultrasound scan of the breast (7.8%, 23/296,), and mammogram (3.7%, 11/296). Women aged 35-44 years had a higher self-perceived risk of breast cancer (adjusted Incident Rate Ratio [aIRR]: 1.75, 95%CI: 1.10-2.80), compared to women aged 18-25 years. ConclusionFirst-degree relatives reported a low self-perceived risk of breast cancer. Breast cancer health education especially targeting younger women should emphasize the increased risk of breast cancer in first-degree relatives of patients with breast cancer. There is a need to increase awareness of breast cancer screening methods and their usefulness in the early detection of breast cancer among all women in Uganda.

Breast Cancer Screening Practice: Early Detection Saves Lives

2018 ◽  
Vol 08 (04) ◽  
Author(s):  
Roy Rillera Marzo ◽  
Dinaramalar Sukkirasingam ◽  
Vimalan Letchumanan ◽  
Shangari Anbarasu ◽  
Thiran Raj Ramiah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Practice

scholarly journals Evaluation issues in the Swedish Two-County Trial of breast cancer screening: An historical review

2016 ◽  
Vol 24 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Laszlo Tabar ◽  
Tony Hsiu-Hsi Chen ◽  
Chen-Yang Hsu ◽  
Wendy Yi-Ying Wu ◽  
Amy Ming-Fang Yen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Controlled Trial ◽  
Historical Review ◽  
Breast Cancer Diagnosis ◽  
Mammographic Screening ◽  
Control Group ◽  
Full Account ◽  
Research Issues

Objectives To summarize debate and research in the Swedish Two-County Trial of mammographic screening on key issues of trial design, endpoint evaluation, and overdiagnosis, and from these to infer promising directions for the future. Methods A cluster-randomized controlled trial of the offer of breast cancer screening in Sweden, with a single screen of the control group at the end of the screening phase forms the setting for a historical review of investigations and debate on issues of design, analysis, and interpretation of results of the trial. Results There has been considerable commentary on the closure screen of the control group, ascertainment of cause of death, and cluster randomization. The issues raised were researched in detail and the main questions answered in publications between 1989 and 2003. Overdiagnosis issues still remain, but methods of estimation taking full account of lead time and of non-screening influences on incidence (taking place mainly before 2005) suggest that it is a minor phenomenon. Conclusion Despite resolution of issues relating to this trial in peer-reviewed publications dating from years, or even decades ago, issues that already have been addressed continue to be raised. We suggest that it would be more profitable to concentrate efforts on current research issues in breast cancer diagnosis, treatment, and prevention.

scholarly journals Observed and Predicted Risk of Breast Cancer Death in Randomized Trials on Breast Cancer Screening

PLoS ONE ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. e0154113 ◽  
Author(s):  
Philippe Autier ◽  
Mathieu Boniol ◽  
Michel Smans ◽  
Richard Sullivan ◽  
Peter Boyle
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Randomized Trials ◽  
Cancer Death ◽  
Breast Cancer Death ◽  
Predicted Risk

scholarly journals Breast cancer screening in average-risk women: towards personalized screening

2019 ◽  
Vol 92 (1103) ◽  
pp. 20190660 ◽  
Author(s):  
Almir GV Bitencourt ◽  
Carolina Rossi Saccarelli ◽  
Christiane Kuhl ◽  
Elizabeth A Morris
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Task Force ◽  
Early Stage ◽  
Breast Cancer Mortality ◽  
Mammographic Screening ◽  
Screening Strategy ◽  
Average Risk ◽  
Early Stage Disease

Breast cancer screening is widely recognized for reducing breast cancer mortality. The objective in screening is to diagnose asymptomatic early stage disease, thereby improving treatment efficacy. Screening recommendations have been widely debated over the past years and controversies remain regarding the optimal screening frequency, age to start screening, and age to end screening. While there are no new trials, follow-up information of randomized controlled trials has become available. The American College of Physicians recently issued a new guidance statement on screening for breast cancer in average-risk women, with similar recommendations to the U.S. Preventive Services Task Force and to European guidelines. However, these guidelines differ from those ofother American specialty societies. The variations reflect differences in the organizations’ values, the metrics used to evaluate screening results, and the differences in healthcare organization (individualized or state-organized healthcare). False-positive rates and overdiagnosis of biologically insignificant cancer are perceived as the most important potential harms associated with mammographic screening; however, there is limited evidence on their actual consequences. Most specialty societies agree that physicians should offer mammographic screening at age 40 years for average-risk women and discuss its benefits and potential harms to achieve a personalized screening strategy through a shared decision-making process.

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