scholarly journals A limited review of over diagnosis methods and long-term effects in breast cancer screening

10.4081/11 ◽  
2011 ◽  
Vol 5 (3) ◽  
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Long Term Effects

scholarly journals A limited review of over diagnosis methods and long-term effects in breast cancer screening

2011 ◽  
pp. 143-147
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Critical Issue ◽  
Long Term Effects ◽  
Screening Programs ◽  
Probability Modeling

Breast cancer screening programs have been effective in detecting tumors prior to symptoms. Recently, there has been concern over the issue of over-diagnosis, that is, diagnosis of a breast cancer that does not manifest prior to death. Estimates for over-diagnosis vary, ranging from 7 to 52%. This variability may be due partially to issues associated with bias and/or incorrect inferences associated with the lack of probability modeling. A critical issue is how to evaluate the long-term effects due to continued screening. Participants in a periodic screening program can be classified into four mutually exclusive groups depending on whether individuals are diagnosed and whether their symptoms appear prior to death: True-earlydetection; No-early-detection; Over-diagnosis; and Not-sonecessary. All initially superficially healthy people will eventually fall into one of these four categories. This manuscript reviews the major methodologies associated with the over-diagnosis and long-term effects of breast cancer screening.

scholarly journals A limited review of over diagnosis methods and long-term effects in breast cancer screening

2011 ◽  
Vol 5 (3) ◽  
pp. 143 ◽  
Author(s):  
Dongfeng Wu ◽  
Adriana Pérez
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Breast Cancer Screening ◽  
Screening Program ◽  
Critical Issue ◽  
Long Term Effects ◽  
Screening Programs ◽  
Probability Modeling

Breast cancer screening programs have been effective in detecting tumors prior to symptoms. Recently, there has been concern over the issue of over-diagnosis, that is, diagnosis of a breast cancer that does not manifest prior to death. Estimates for over-diagnosis vary, ranging from 7 to 52%. This variability may be due partially to issues associated with bias and/or incorrect inferences associated with the lack of probability modeling. A critical issue is how to evaluate the long-term effects due to continued screening. Participants in a periodic screening program can be classified into four mutually exclusive groups depending on whether individuals are diagnosed and whether their symptoms appear prior to death: True-earlydetection; No-early-detection; Over-diagnosis; and Not-sonecessary. All initially superficially healthy people will eventually fall into one of these four categories. This manuscript reviews the major methodologies associated with the over-diagnosis and long-term effects of breast cancer screening.

Effect of false-positives and women’s characteristics on long-term adherence to breast cancer screening

2011 ◽  
Vol 130 (2) ◽  
pp. 543-552 ◽  
Author(s):  
R. Román ◽  
M. Sala ◽  
M. De La Vega ◽  
C. Natal ◽  
J. Galceran ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
False Positives

scholarly journals Long-Term Outcomes and Cost-Effectiveness of Breast Cancer Screening With Digital Breast Tomosynthesis in the United States

2019 ◽  
Vol 112 (6) ◽  
pp. 582-589 ◽  
Author(s):  
Kathryn P Lowry ◽  
Amy Trentham-Dietz ◽  
Clyde B Schechter ◽  
Oguzhan Alagoz ◽  
William E Barlow ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
False Positive ◽  
Digital Breast Tomosynthesis ◽  
The United States ◽  
Breast Tomosynthesis

Abstract Background Digital breast tomosynthesis (DBT) is increasingly being used for routine breast cancer screening. We projected the long-term impact and cost-effectiveness of DBT compared to conventional digital mammography (DM) for breast cancer screening in the United States. Methods Three Cancer Intervention and Surveillance Modeling Network breast cancer models simulated US women ages 40 years and older undergoing breast cancer screening with either DBT or DM starting in 2011 and continuing for the lifetime of the cohort. Screening performance estimates were based on observational data; in an alternative scenario, we assumed 4% higher sensitivity for DBT. Analyses used federal payer perspective; costs and utilities were discounted at 3% annually. Outcomes included breast cancer deaths, quality-adjusted life-years (QALYs), false-positive examinations, costs, and incremental cost-effectiveness ratios (ICERs). Results Compared to DM, DBT screening resulted in a slight reduction in breast cancer deaths (range across models 0–0.21 per 1000 women), small increase in QALYs (1.97–3.27 per 1000 women), and a 24–28% reduction in false-positive exams (237–268 per 1000 women) relative to DM. ICERs ranged from $195 026 to $270 135 per QALY for DBT relative to DM. When assuming 4% higher DBT sensitivity, ICERs decreased to $130 533–$156 624 per QALY. ICERs were sensitive to DBT costs, decreasing to $78 731 to $168 883 and $52 918 to $118 048 when the additional cost of DBT was reduced to $36 and $26 (from baseline of $56), respectively. Conclusion DBT reduces false-positive exams while achieving similar or slightly improved health benefits. At current reimbursement rates, the additional costs of DBT screening are likely high relative to the benefits gained; however, DBT could be cost-effective at lower screening costs.

Long-term impact of previous breast biopsy on breast cancer screening modalities

1995 ◽  
Vol 59 (1) ◽  
pp. 18-20 ◽  
Author(s):  
James M. Goff ◽  
Mark Molloy ◽  
Maureen T. Debbas ◽  
Douglas A. Hale ◽  
David P. Jaques
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Breast Biopsy ◽  
Long Term Impact

scholarly journals P1-308 Effect of false-positives and women's characteristics on the long-term attitude towards breast cancer screening

2011 ◽  
Vol 65 (Suppl 1) ◽  
pp. A152-A152
Author(s):  
R. Roman ◽  
M. Sala ◽  
R. Zubuzarreta ◽  
I. Delfrade ◽  
D. Salas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
False Positives
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