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Efficacy of screening mammography. A meta-analysis
K Kerlikowske1, D Grady, S M Rubin
1Department of Epidemiology and Biostatistics, University of California, San Francisco.
JAMA
|January 11, 1995
Summary
Screening mammography effectively lowers breast cancer mortality in women aged 50-74. For women aged 40-49, benefits are not significant with shorter follow-up but may emerge after 10-12 years.
Area of Science:
- Oncology
- Radiology
- Preventive Medicine
Background:
- Screening mammography is a key tool for early breast cancer detection.
- Its efficacy varies by age group, influencing screening guidelines.
- Understanding these variations is crucial for optimizing public health strategies.
Purpose of the Study:
- To evaluate the effectiveness of screening mammography.
- To analyze efficacy based on patient age, mammogram views, screening frequency, and follow-up duration.
- To provide evidence-based recommendations for mammography screening protocols.
Main Methods:
- A comprehensive literature review and meta-analysis were conducted.
- Data from English-language studies published between 1966 and 1993 were systematically searched and analyzed.
- Thirteen selected studies were synthesized using fixed-effects meta-analytic techniques.
Main Results:
- Screening mammography showed a significant reduction in breast cancer mortality (RR=0.74) for women aged 50-74.
- This benefit was consistent across different numbers of mammographic views, screening intervals, and follow-up durations.
- No significant mortality reduction was observed for women aged 40-49, with relative risks not significantly less than 1.0.
Conclusions:
- Screening mammography significantly reduces breast cancer mortality in women aged 50-74.
- Efficacy in women aged 40-49 is not established with 7-9 years of follow-up.
- Delayed screening or starting at menopause/age 50 may offer similar benefits for younger women.