Comparison of recommendations for screening mammography using CISNET models.

Area of Science:

• Oncology
• Preventive Medicine
• Biostatistics

Background:

• Multiple national organizations provide varied recommendations for screening mammography.
• Recommendations include annual screening (ages 40-84), hybrid schedules (annual 45-54, biennial 55-79), and biennial screening (ages 50-74).

Purpose of the Study:

• To compare the benefits and risks of three distinct screening mammography guidelines.
• To evaluate mortality reduction and potential harms associated with different screening frequencies and starting ages.

Main Methods:

• Utilized mean values from six Cancer Intervention and Surveillance Modeling Network (CISNET) models.
• Compared three primary screening mammography recommendations based on simulated outcomes.

Main Results:

• Annual screening from age 40 yielded the highest mean mortality reduction (39.6%).
• This strategy averted the most breast cancer deaths (29,369 per cohort) but also resulted in the highest number of mammograms, benign recalls, and biopsies.
• Biennial screening (ages 50-74) showed the lowest mortality benefit (23.2%) and fewest associated harms.

Conclusions:

• Annual mammography screening for women starting at age 40 achieves the greatest reduction in breast cancer mortality.
• The choice of screening strategy involves balancing maximal mortality benefit against increased screening procedures and potential harms.