Breast cancer screening and overdiagnosis.
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State: Public
Version: Final published version
License: All rights reserved
Serval ID
serval:BIB_2D9C1057069C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Breast cancer screening and overdiagnosis.
Journal
International journal of cancer
ISSN
1097-0215 (Electronic)
ISSN-L
0020-7136
Publication state
Published
Issued date
15/08/2021
Peer-reviewed
Oui
Volume
149
Number
4
Pages
846-853
Language
english
Notes
Publication types: Journal Article
Abstract
Overdiagnosis is a harmful consequence of screening which is particularly challenging to estimate. An unbiased setting to measure overdiagnosis in breast cancer screening requires comparative data from a screened and an unscreened cohort for at least 30 years. Such randomised data will not become available, leaving us with observational data over shorter time periods and outcomes of modelling. This collaborative effort of the International Cancer Screening Network quantified the variation in estimated breast cancer overdiagnosis in organised programmes with evaluation of both observed and simulated data, and presented examples of how modelling can provide additional insights. Reliable observational data, analysed with study design accounting for methodological pitfalls, and modelling studies with different approaches, indicate that overdiagnosis accounts for less than 10% of invasive breast cancer cases in a screening target population of women aged 50 to 69. Estimates above this level are likely to derive from inaccuracies in study design. The widely discrepant estimates of overdiagnosis reported from observational data could substantially be reduced by use of a cohort study design with at least 10 years of follow-up after screening stops. In contexts where concomitant opportunistic screening or gradual implementation of screening occurs, and data on valid comparison groups are not readily available, modelling of screening intervention becomes an advantageous option to obtain reliable estimates of breast cancer overdiagnosis.
Keywords
breast cancer, estimation, methodology, overdiagnosis, screening, adult, aged, aging, article, cancer screening, cohort analysis, comparative study, diagnostic error, female, follow up, human, intersectoral collaboration, major clinical study, mathematical model, observational study
Pubmed
Web of science
Create date
26/04/2021 10:01
Last modification date
01/08/2024 7:04