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...
How artificial intelligence is spotting breast cancer better than some physicians.
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
ConclusionSurgical clips can be used safely to replace the usual commercial markers in the localization of breast cancer before NAC. They showed effective results with no complications, don't interfere with the patients' imaging and of the significant low cost compared to the commercial ones.
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]
ConclusionCBBCT showed equal aptitude and better agreement for the breast density evaluation compared to mammography. CBBCT could be an effective modality for breast density assessment and breast cancer risk evaluation in routine diagnosis and breast cancer screening.
Nursing home patients may be frail or have other diseases, leading some doctors to advise hormone therapy rather than operations.
Precision risk-based screening might maximize benefit and minimize harm, Published online: 14 September 2018; doi:10.1038/s41571-018-0093-0Population-based mammographic screening is widely accepted as an intervention to reduce overall mortality from breast cancer, but at the cost of morbidity due to false positives and substantial overdiagnosis and overtreatment of ultra-low-risk disease, as well as personal and health-economic burdens. Recent data from a modelling study strengthen the rationale for personalized, risk-based screening approaches, now being tested in multiple clinical trials.
The findings of a new Danish-Norwegian study are reviving the claim that the...Read more on AuntMinnie.comRelated Reading: Annual mammography at 40 cuts mortality most Fewer high-risk women get mammography after USPSTF change Is the mammography debate an example of 'fake science'? JNCI study revives debate over mammography's mortality benefit Mammography reduces breast cancer mortality in younger women
In honor of October ’s Breast Cancer Awareness Month, UR Medicine Breast Imaging – in conjunction with the Breast Cancer Coalition of Rochester, Cancer Services Program of Monroe County, and Susan G. Komen Upstate NY – is offering free annual mammograms to women age 40 and older. The screening sessions will be he ld at UR Medicine Breast Imaging at Anthony Jordan Health Center on Saturday, September 15 from 9 a.m. to 1 p.m. and UR Medicine Breast Imaging at Red Creek on Saturday, October 6 from 8 a.m. to 12 p.m.
CONCLUSION: The dCNN allows for accurate classification of breast density based on the ACR BI-RADS system. The proposed technique may allow accurate, standardized, and observer independent breast density evaluation of mammographies. Advances in Knowledge: Standardized classification of mammographies by a dCNN could lead to a reduction of falsely classified breast densities, thereby allowing for a more accurate breast cancer risk assessment for the individual patient and a more reliable decision, whether additional ultrasound is recommended. PMID: 30209957 [PubMed - as supplied by publisher]