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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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Women who forgo mammography screening may comply less to breast cancer treatment and may have worse outcomes, suggest two European studies, which also found that rates of screening may be falling.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Hematology-Oncology News Source Type: news
All women aged between 50 and 70 are offered screening for breast cancer. But how effective is it at stopping deaths – and might it actually do more harm than good?Many of us will know someone who had breast cancer found at screening. The cancer seen on a mammogram may have been microscopic, so early in its malignant life that it hadn ’t broken through the wall of its milk duct. Thank heavens, then, for breast screening, which is offered to all women between 50 and 70 in the UK and other countries. It is promoted enthusiastically as lifesaving, but does it deliver on its promise? And are the randomised con...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Health & wellbeing Life and style Breast cancer Society Cancer research Medical research Science Source Type: news
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Source: Caroline's Breast Cancer Blog - Category: Cancer & Oncology Tags: breast cancer cancer diagnosis mammogram personalized medicine Source Type: blogs
Conclusions: In the absence of a national screening program for breast cancer, the high-risk approach for screening should be considered. Women with the above characteristics should be identified and motivated to seek mammogram regularly to warrant a better outcome. PMID: 29218120 [PubMed]
Source: Oman Medical Journal - Category: Middle East Health Tags: Oman Med J Source Type: research
In the Netherlands, 24 years of mammography screening had no effect on reducing rates of advanced cancer but resulted in overdiagnosis in a third of women.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Hematology-Oncology News Source Type: news
(University of Chicago Medical Center) Intensive surveillance including a dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) exam every six months was far more effective in detecting breast cancer in younger women with a high-risk genetic profile than an annual mammogram. DCE-MRI every six months performed well for early detection of invasive breast cancer in high-risk women.
Source: EurekAlert! - Biology - Category: Biology Source Type: news
(University of Pennsylvania School of Medicine) Although digital breast tomosynthesis (DBT), or 3-D mammography, costs more than a digital mammography (DM) screening, it actually may help rein in cancer screening costs, according to preliminary findings (PD7-05) presented by researchers from the Perelman School of Medicine at the University of Pennsylvania during the 2017 San Antonio Breast Cancer Symposium.
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Source: Journal of Cellular Physiology - Category: Cytology Authors: Tags: REVIEW ARTICLE Source Type: research
Health officials are starting a huge study to tell if the newer, sometimes pricier scans really improve screening for breast cancer
Source: Health News: CBSNews.com - Category: Consumer Health News Source Type: news
Health officials are starting a huge study to tell if the newer, sometimes pricier scans really improve screening for breast cancer
Source: Health News: CBSNews.com - Category: Consumer Health News Source Type: news
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