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The evidence to support mammography screening.

W A van Veen1, J A Knottnerus

  • 1Health Council of The Netherlands, The Hague. wa.van.veen@gr.nl

The Netherlands Journal of Medicine
|October 9, 2002
PubMed
Summary

A Cochrane review questioned mammography screening

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Area of Science:

  • Oncology
  • Public Health
  • Evidence-Based Medicine

Background:

  • A recent Cochrane review challenged the efficacy and safety of mammography screening.
  • This review suggested that mammography screening does not reduce mortality and may cause harm.

Purpose of the Study:

  • To evaluate the validity of the Cochrane review's conclusions regarding mammography screening.
  • To provide an advisory report to the Dutch government on breast cancer screening programmes.

Main Methods:

  • The committee reviewed the evidence cited in the Cochrane review, including six eligible trials.
  • They assessed the methodology and conclusions of the Cochrane review, focusing on the exclusion of trials and the choice of outcome measures.
  • The committee considered breast cancer mortality, all-cancer mortality, and all-cause mortality.

Main Results:

  • The committee found no convincing reasons to exclude most of the trials analyzed by Cochrane.
  • They concluded that the Cochrane review's findings do not invalidate the evidence supporting mammography screening for women aged 50 and over.
  • The committee disagreed with the extreme conclusions regarding breast cancer mortality as an unreliable outcome.

Conclusions:

  • The Cochrane review's conclusions regarding mammography screening are not fully supported by the evidence.
  • Breast cancer screening programmes for women aged 50+ remain supported by robust evidence.
  • Interpreting screening trial results requires considering breast cancer mortality alongside all-cancer and all-cause mortality.

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