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Related Experiment Videos

Mammographic screening: evidence from randomised controlled trials.

H J de Koning1

  • 1Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands. h.dekoning@erasmusmc.nl

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|July 26, 2003
PubMed
Summary

Mammography screening trials demonstrate a 25% reduction in breast cancer mortality for women aged 50+. Despite varying results, breast cancer mortality remains a valid outcome measure for screening programs.

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Area of Science:

  • Oncology
  • Public Health
  • Radiology

Background:

  • Randomized breast cancer screening trials consistently show reduced mortality for women aged 50+ invited for mammography.
  • Variations in reported mortality reduction estimates and concerns regarding trial methodology and outcome measures exist.

Purpose of the Study:

  • To review evidence on breast cancer mortality reduction from screening trials.
  • To discuss factors influencing differing point estimates in breast cancer mortality reduction.
  • To evaluate breast cancer mortality as a valid outcome measure for screening trials.

Main Methods:

  • Review of evidence from randomized breast cancer screening trials.
  • Analysis of methodological quality and outcome measures in selected trials.

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  • Examination of data supporting breast cancer mortality as a primary outcome.

    • Main Results:

    • Breast cancer mortality is a clinically and methodologically sound outcome measure for screening trials.
    • Accurate determination of breast cancer mortality was prioritized in the reviewed trials.
    • Observed differences in mortality reduction rates are explainable by trial design, regional context, and screening quality.

    Conclusions:

    • Current nationwide population-based breast cancer screening programs should continue.
    • There is no justification for negative reporting regarding mammography screening effectiveness.
    • Continued population-based screening is supported by the evidence on mortality reduction.