scholarly journals A method for evaluating breast cancer screening strategies using screen-preventable loss of life

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243113
Author(s):  
Kimbroe J. Carter ◽  
Frank Castro ◽  
Roy N. Morcos
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Task Force ◽  
Mammographic Screening ◽  
American Cancer Society ◽  
Cancer Society ◽  
Loss Of Life ◽  
Screening Guidelines ◽  
Clinical Awareness

The objective of this study is to describe how screen-preventable loss of life (screen-PLL) can be used to analyze the distribution of life savings with mammographic screening. The determination of screen-PLL with mammography is possible using a natural history model of breast cancer that simulates clinical and pathologic events of this disease. This investigation uses a Monte Carlo Markov model with data from the Surveillance, Epidemiology, and End Results Program; American Cancer Society; and National Vital Statistics System. Populations of one million women per screening strategy are simulated over a lifetime with mammographic screening based on current guidelines of the American Cancer Society (ACS), United States Preventive Services Task Force (USPSTF), triennial screening from age 50–70, and no screening. Screen-PLL curves are generated and show guideline performance over a lifetime. The screen-PLL curve with no screening is determined by tumor discovery through clinical awareness and has the highest values of screen-PLL. The ACS and USPSTF strategies demonstrate screen-PLL curves favoring the elderly. The curve for triennial screening is more uniform than the ACS or USPSTF curves but could be improved by adding screen(s) at either end of the 50–70 age range. This study introduces the use of screen-PLL as a tool to improve the understanding of screening guidelines and allowing a more balanced allocation of life savings across an aging population. The method presented shows how screen-PLL can be used to analyze and potentially improve breast cancer screening guidelines.

scholarly journals American Cancer Society Guidelines for Breast Cancer Screening: Update 2003

2003 ◽  
Vol 53 (3) ◽  
pp. 141-169 ◽  
Author(s):  
R. A. Smith ◽  
D. Saslow ◽  
K. Andrews Sawyer ◽  
W. Burke ◽  
M. E. Costanza ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
American Cancer Society ◽  
Cancer Society

Breast cancer screening guidelines: Is it time to revisit? A survey.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11089-e11089
Author(s):  
Archana C. Rao ◽  
Srivalli Gopaluni ◽  
Sheila M. Lemke
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Health Care Providers ◽  
Task Force ◽  
University Hospital ◽  
Care Providers ◽  
Cancer Society ◽  
Adherence To Guidelines ◽  
Screening Guidelines ◽  
Cancer Network

e11089 Background: Breast cancer is the most common non-skin cancer among women in US. In a 2012 report by CDCbreast cancer screening rates are falling short of government targets. At least 10 different societies have laid out screening guidelines, making it difficult to follow. We conducted a survey to better understand adherence to guidelines among health care providers. Methods: A questionnaire comprising of 15 questions was distributed to 120 providers within the Department of Medicine at a University Hospital. Results: 68% returned completed questionnaires: Residents (53%), Attendings/Fellows (36%) and Nurse Practioners/Medical students (11%). Despite 60% respondents claiming that screening guidelines were easy to comprehend and follow; the table suggests otherwise. 49% of the respondents follow United States Preventive Services Task Force guidelines (USPSTF) 28% of these commenced screening at age 40; against the recommendations to start at age 50 and to initiate discussions between the ages of 40-50. 16% of the respondents followed National Comprehensive Cancer Network (NCCN)/American Cancer Society guidelines. 46% of these commenced screening at age 50 or between ages 40-50 contrary to recommendations to begin screening at age 40. Similarly 42% of respondents chose to discontinue screening at the age of 75 in concordance to USPSTF guidelines. 5% chose to screen indefinitely and 1% said they would individualize. 52% did not conform to any guidelines. 69% advocated self breast examinations despite most societies not encouraging the same. Conclusions: While majority of providers follow USPSTF guidelines, there is a considerable discordance between guidelines respondents claim to follow and their practices. This could be attributed to the lack of uniformity in the guidelines across various societies making it harder to comprehend and recall. A unifying consensus would make it easier for providers to improve effective screening. [Table: see text]

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.

scholarly journals Breast cancer screening patterns in Jamaican women: review of the largest national mammography clinic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sheray N. Chin ◽  
Derria Cornwall ◽  
Derek I. Mitchell ◽  
Michael E. McFarlane ◽  
Joseph M. Plummer
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Cancer Diagnosis ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Screening Guidelines ◽  
National Breast ◽  
Jamaican Women ◽  
The Impact

Abstract Background Breast cancer is the leading cause of cancer and cancer related deaths in Jamaican women. In Jamaica, women often present with advanced stages of breast cancer, despite the availability of screening mammography for early detection. The utilization of screening mammography for early breast cancer diagnosis seems to be limited, and this study investigated the national patterns of mammographic screening and the impact of mammography on the diagnosis of breast cancer in Jamaica. Methods A retrospective analysis of the records of the largest mammography clinic in Jamaica was done for the period January 2011 to December 2016. Descriptive statistics was performed on relevant patient characteristics with calculation of rates and proportions; cross-tabulations were utilized to assess relationship of covariates being studied on the outcomes of interest. Results are reported in aggregate form with no identifiable patient data. Results 48,203 mammograms were performed during the study period. 574 women (1.2%) had mammograms suspicious for breast cancer with median age of 57 years (range 30–95 years); 35% were under the age of 50. 4 women with suspicious findings had undergone ‘screening mammography’, with the remaining having ‘diagnostic mammography’. 38% reported previous mammograms, with a mean interval of 8 years between previous normal mammogram and mammogram suspicious for breast cancer. Median age at first screening mammogram was 51 years (range 41–77). Conclusion Breast cancer screening mammography is underutilized in Jamaica. An organized national breast cancer screening programme is recommended to improve adherence to international breast cancer screening guidelines.

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