Why mammography screening has not lived up to expectations from the randomised trials.

We analysed the relation between tumour sizes and stages and the reported effects on breast cancer mortality with and without screening in trials and observational studies. The average tumour sizes in all the trials suggest only a 12% reduction in breast cancer mortality, which agrees with the 10% r...

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Publicado en:Cancer Causes & Control Vol. 23; no. 1; pp. 15 - 22
Autores principales: Gøtzsche PC, Jørgensen KJ, Zahl PH, Mæhlen J, Gøtzsche, Peter C, Jørgensen, Karsten Juhl, Zahl, Per-Henrik, Mæhlen, Jan
Formato: review Journal Article
Publicado: Springer Nature Jan2012
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Why mammography screening has not lived up to expectations from the randomised trials.
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        au:
          Gøtzsche PC
          Jørgensen KJ
          Zahl PH
          Mæhlen J
          Gøtzsche, Peter C
          Jørgensen, Karsten Juhl
          Zahl, Per-Henrik
          Mæhlen, Jan
        affil: Dept 3343, The Nordic Cochrane Centre, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
      sug:
        subj:
          Breast Neoplasms Prevention and Control
          Breast Neoplasms Radiography
          Mammography Methods
          Breast Neoplasms Diagnosis
          Breast Neoplasms Pathology
          Clinical Trials
          Early Detection of Cancer Methods
          Female
          Health Screening
          Incidence
          Neoplasm Staging
          Female
      ab: We analysed the relation between tumour sizes and stages and the reported effects on breast cancer mortality with and without screening in trials and observational studies. The average tumour sizes in all the trials suggest only a 12% reduction in breast cancer mortality, which agrees with the 10% reported in the most reliable trials. Recent studies of tumour sizes and tumour stages show that screening has not lowered the rate of advanced cancers. In agreement with this, recent observational studies of breast cancer mortality have failed to find an effect of screening. In contrast, screening leads to serious harms in healthy women through overdiagnosis with subsequent overtreatment and false-positive mammograms. We suggest that the rationale for breast screening be urgently reassessed by policy-makers. The observed decline in breast cancer mortality in many countries seems to be caused by improved adjuvant therapy and breast cancer awareness, not screening. We also believe it is more important to reduce the incidence of cancer than to detect it 'early.' Avoiding getting screening mammograms reduces the risk of becoming a breast cancer patient by one-third.
      pubtype: Academic Journal
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    language: English
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