Benefits and harms of annual, biennial, or triennial breast cancer mammography screening for women at average risk of breast cancer : a systematic review for the European Commission Initiative on Breast Cancer (ECIBC)
Canelo Aybar, Carlos Gilberto (Institut d'Investigació Biomèdica Sant Pau)
Posso, Margarita (Hospital del Mar (Barcelona, Catalunya))
Montero, Nadia (Centro Cochrane Iberoamericano (CCIb))
Solà, Ivan (Institut d'Investigació Biomèdica Sant Pau)
Saz-Parkinson, Zuleika (European Commission. Joint Research Centre (JRC))
Duffy, Stephen W. (Wolfson Institute of Preventive Medicine. Queen Mary University of London)
Follmann, Markus (German Cancer Society)
Gräwingholt, Axel (Radiologie am Theater)
Giorgi Rossi, Paolo (Azienda Unità Sanitaria Locale di Reggio Emilia. Instituto in tecnologie avanzate e modelli assistenziali in oncologia)
Alonso-Coello, Pablo (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Background: Although mammography screening is recommended in most European countries, the balance between the benefits and harms of different screening intervals is still a matter of debate. This review informed the European Commission Initiative on Breast Cancer (BC) recommendations. Methods: We searched PubMed, EMBASE, and the Cochrane Library to identify RCTs, observational or modelling studies, comparing desirable (BC deaths averted, QALYs, BC stage, interval cancer) and undesirable (overdiagnosis, false positive related, radiation related) effects from annual, biennial, or triennial mammography screening in women of average risk for BC. We assessed the certainty of the evidence using the GRADE approach. Results: We included one RCT, 13 observational, and 11 modelling studies. In women 50-69, annual compared to biennial screening may have small additional benefits but an important increase in false positive results; triennial compared to biennial screening may have smaller benefits while avoiding some harms. In younger women (aged 45-49), annual compared to biennial screening had a smaller gain in benefits and larger harms, showing a less favourable balance in this age group than in women 50-69. In women 70-74, there were fewer additional harms and similar benefits with shorter screening intervals. The overall certainty of the evidence for each of these comparisons was very low. Conclusions: In women of average BC risk, screening intervals have different trade-offs for each age group. The balance probably favours biennial screening in women 50-69. In younger women, annual screening may have a less favourable balance, while in women aged 70-74 years longer screening intervals may be more favourable.
Ayudas:	European Commission 443094
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Adult ; Age Factors ; Aged ; Breast Neoplasms ; Early Detection of Cancer ; Europe ; False Positive Reactions ; Female ; Humans ; Mammography ; Middle Aged ; Observational Studies as Topic ; Practice Guidelines as Topic ; Risk Assessment
Publicado en:	British journal of cancer, Vol. 126 Núm. 4 (september 2022) , p. 673-688, ISSN 1532-1827

DOI: 10.1038/s41416-021-01521-8
PMID: 34837076

16 p, 581.3 KB

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