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Breast cancer screening: a 35-year perspective.
1Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 133 Brookline Avenue, 6th Floor, Boston, MA 02215, USA. suzanne_fletcher@hms.harvard.edu
Epidemiologic Reviews
|June 24, 2011
Summary
Breast cancer screening has a long history, highlighting successes and challenges. Future cancer screening evaluations require new methods to address evolving technologies and overdiagnosis.
Area of Science:
- Oncology
- Preventive Medicine
- Health Services Research
Background:
- Breast cancer screening has been evaluated by 9 randomized trials over 5 decades.
- Major guideline groups have recommended breast cancer screening for over 3 decades.
Observation:
- Scientific methods for evaluating screening have been developed.
- Assessing new screening technologies presents challenges.
- False-positive results and overdiagnosis are significant issues in cancer screening.
- Stratifying individuals by breast cancer risk remains difficult.
Findings:
- Randomized trials have been crucial for past screening evaluations.
- New methods are increasingly needed to evaluate future cancer screening.
- Public communication regarding evidence-based screening guidelines is essential.
Implications:
- Improved cancer treatment and primary prevention may reduce the future need for screening.
- Addressing false positives and overdiagnosis is critical for effective cancer screening.
- Clearer communication about screening guidelines is needed to ensure public and clinical adherence.
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