Disaggregating the mortality reductions due to cancer screening: model-based estimates from population-based data

AbstractThe mortality impact in cancer screening trials and population programs is usually expressed as a single hazard ratio or percentage reduction. This measure ignores the number/spacing of rounds of screening, and the location in follow-up time of the averted deaths vis-a-vis the first and last screens. If screening works as intended, hazard ratios are a strong function of the two Lexis time-dimensions. We show how the number and timing of the rounds of screening can be included in a model that specifies what each round of screening accomplishes. We show how this model can be used to disaggregate the observed reductions (i.e., make them time-and screening-history specific), and to project the impact of other regimens. We use data on breast cancer screening to illustrate this model, which we had already described in technical terms in a statistical journal. Using the numbers of invitations different cohorts received, we fitted the model to the age- and follow-up-year-specific numbers of breast cancer deaths in Funen, Denmark. From November 1993 onwards, women aged 50 –69 in Funen were invited to mammography screening every two years, while those in comparison regions were not. Under the proportional hazards model, the overall fitted hazard ratio was 0.82 (average reduction 18%). Using a (non-proportional-hazards) model that included the timing information, th e fitted reductions ranged from 0 to 30%, being largest in those Lexis cells that had received the grea...
Source: European Journal of Epidemiology - Category: Epidemiology Source Type: research

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Last week was a bad one for opponents of breast cancer screening. On Saturday,...Read more on AuntMinnie.comRelated Reading: Breast screening skeptic Welch accused of plagiarism JAMA: Women need to be aware of mammography's harms ACR disputes NEJM paper on overdiagnosis Study questions value of early breast cancer detection NEJM: Treatment, not screening, cuts breast cancer deaths
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Source: The Egyptian Journal of Radiology and Nuclear Medicine - Category: Nuclear Medicine Source Type: research
Conclusions: Mammography is the best technique for screening and identifying patients with non-mass-like breast lesions and microcalcifications. Considering the false positive and false-negative results, ultrasound is not a perfect screening modality. Future studies are recommended to study the value of ultrasound in the detection of high-risk breast cancer patients. PMID: 30210716 [PubMed]
Source: Oman Medical Journal - Category: Middle East Health Tags: Oman Med J Source Type: research
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Source: Academic Radiology - Category: Radiology Source Type: research
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Source: NYT Health - Category: Consumer Health News Authors: Tags: Mammography Breast Cancer Surgery and Surgeons Elderly Nursing Homes Dr. Mara Schonberg Source Type: news
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Source: Nature Clinical Practice Oncology - Category: Cancer & Oncology Authors: Source Type: research
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Source: University of Rochester Medical Center Press Releases - Category: Universities & Medical Training Authors: Source Type: news
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Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
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