Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort.

Details

Serval ID
serval:BIB_1D176A71BD54
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort.
Journal
Annals of internal medicine
Author(s)
Ryser M.D., Lange J., Inoue LYT, O'Meara E.S., Gard C., Miglioretti D.L., Bulliard J.L., Brouwer A.F., Hwang E.S., Etzioni R.B.
ISSN
1539-3704 (Electronic)
ISSN-L
0003-4819
Publication state
Published
Issued date
04/2022
Peer-reviewed
Oui
Volume
175
Number
4
Pages
471-478
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Mammography screening can lead to overdiagnosis-that is, screen-detected breast cancer that would not have caused symptoms or signs in the remaining lifetime. There is no consensus about the frequency of breast cancer overdiagnosis.
To estimate the rate of breast cancer overdiagnosis in contemporary mammography practice accounting for the detection of nonprogressive cancer.
Bayesian inference of the natural history of breast cancer using individual screening and diagnosis records, allowing for nonprogressive preclinical cancer. Combination of fitted natural history model with life-table data to predict the rate of overdiagnosis among screen-detected cancer under biennial screening.
Breast Cancer Surveillance Consortium (BCSC) facilities.
Women aged 50 to 74 years at first mammography screen between 2000 and 2018.
Screening mammograms and screen-detected or interval breast cancer.
The cohort included 35 986 women, 82 677 mammograms, and 718 breast cancer diagnoses. Among all preclinical cancer cases, 4.5% (95% uncertainty interval [UI], 0.1% to 14.8%) were estimated to be nonprogressive. In a program of biennial screening from age 50 to 74 years, 15.4% (UI, 9.4% to 26.5%) of screen-detected cancer cases were estimated to be overdiagnosed, with 6.1% (UI, 0.2% to 20.1%) due to detecting indolent preclinical cancer and 9.3% (UI, 5.5% to 13.5%) due to detecting progressive preclinical cancer in women who would have died of an unrelated cause before clinical diagnosis.
Exclusion of women with first mammography screen outside BCSC.
On the basis of an authoritative U.S. population data set, the analysis projected that among biennially screened women aged 50 to 74 years, about 1 in 7 cases of screen-detected cancer is overdiagnosed. This information clarifies the risk for breast cancer overdiagnosis in contemporary screening practice and should facilitate shared and informed decision making about mammography screening.
National Cancer Institute.
Keywords
Bayes Theorem, Breast Neoplasms/diagnostic imaging, Breast Neoplasms/epidemiology, Early Detection of Cancer, Female, Humans, Male, Mammography, Mass Screening, Overdiagnosis
Pubmed
Web of science
Create date
07/03/2022 12:12
Last modification date
27/04/2022 6:37
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