programas cribado cancer

Nota bibliográfica cribado c mama 2013-01

Domingo L, Jacobsen KK, von Euler-Chelpin M, Vejborg I, Schwartz W, Sala M, et al. Seventeen-years overview of breast cancer inside and outside screening in Denmark. Acta Oncol 2013;52(1):48-56.

McCarthy N. What's a girl to do? Nat Rev Cancer 2013 print;13(1):9-9.Enlace:

Protocols for the surveillance of women at higher risk of developing breast cancer. 2012;NHSBSP Publication No 74.

Álvaro-Meca A, Debón A, Gil Prieto R, Gil de Miguel Á. Breast cancer mortality in Spain: Has it really declined for all age groups? Public Health 2012 10;126(10):891-895. DOI:10.1016/j.puhe.2012.05.031. PMID:22921339.

Autier P, Boniol M. Breast cancer screening: evidence of benefit depends on the method used. BMC Med 2012 Dec 12;10:163-7015-10-163. DOI:10.1186/1741-7015-10-163; 10.1186/1741-7015-10-163. PMID:23234249.

ABSTRACT: In this article, we discuss the most common epidemiological methods used for evaluating the ability of mammography screening to decrease the risk of breast cancer death in general populations (effectiveness). Case-control studies usually find substantial effectiveness. However when breast cancer mortality decreases for reasons unrelated to screening, the case-control design may attribute to screening mortality reductions due to other causes. Studies based on incidence-based mortality have obtained contrasted results compatible with modest to considerable effectiveness, probably because of differences in study design and statistical analysis. In areas where screening has been widespread for a long time, the incidence of advanced breast cancer should be decreasing, which in turn would translate into reduced mortality. However, no or modest declines in the incidence of advanced breast cancer has been observed in these areas. Breast cancer mortality should decrease more rapidly in areas with early introduction of screening than in areas with late introduction of screening. Nonetheless, no difference in breast mortality trends has been observed between areas with early or late screening start. When effectiveness is assessed using incidence-based mortality studies, or the monitoring of advanced cancer incidence, or trends in mortality, the ecological bias is an inherent limitation that is not easy to control. Minimization of this bias requires data over long periods of time, careful selection of populations being compared and availability of data on major confounding factors. If case-control studies seem apparently more adequate for evaluating screening effectiveness, this design has its own limitations and results must be viewed with caution.
Hersch J, Jansen J, Barratt A, Irwig L, Houssami N, Howard K, et al. Women's views on overdiagnosis in breast cancer screening: a qualitative study. BMJ 2013 Jan 23;346:f158. DOI:10.1136/bmj.f158. PMID:23344309.

CONCLUSIONS: Women from a range of socioeconomic backgrounds could comprehend the issue of overdiagnosis in mammography screening, and they generally valued information about it. Effects on screening intentions may depend heavily on the rate of overdiagnosis. Overdiagnosis will be new and counterintuitive for many people and may influence screening and treatment decisions in unintended ways, underscoring the need for careful communication.

Fiona Godlee. Breast screening controversy continues. BMJ 2013 BMJ Publishing Group Ltd;346 DOI:10.1136/bmj.f477.

Marmot and his committee were charged with asking whether the screening programme should continue, and if so, what women should be told about the risks of overdiagnosis.As nicely summarised by Nigel Hawkes at the time (BMJ 2012;345:e7330), the committee concluded that the programme should continue because it did prevent deaths—43 deaths

Cliona C Kirwan. Breast cancer screening: what does the future hold? (editorial). BMJ 2013 BMJ Publishing Group Ltd;346 DOI:10.1136/bmj.f87.

Michael Baum. Harms from breast cancer screening outweigh benefits if death caused by treatment is included. BMJ 2013 BMJ Publishing Group Ltd;346 DOI:10.1136/bmj.f385.

Dore C, Gallagher F, Saintonge L, Hebert M. Breast cancer screening program: experiences of Canadian women and their unmet needs. Health Care Women Int 2013;34(1):34-49. DOI:10.1080/07399332.2012.673656; 10.1080/07399332.2012.673656. PMID:23216095.

The aim of this study was to describe the experiences of women waiting for results from the Quebec Breast Cancer Screening Program and their need for support. A qualitative analysis of the interviews generated a description of (a) the experiences and emotions of women waiting for mammogram results and (b) the need for services and psychosocial support that were and were not met. The results revealed a "timeline" of the waiting process experienced by the women, and their unmet informational and psychosocial needs (such as a lack of information about the prediagnosis steps, lack of a resource person, and others).

Payne JI, Caines JS, Gallant J, Foley TJ. A review of interval breast cancers diagnosed among participants of the Nova Scotia Breast Screening Program. Radiology 2013 Jan;266(1):96-103. DOI:10.1148/radiol.12102348; 10.1148/radiol.12102348. PMID:23169791.

CONCLUSION: In screening programs, true interval cancer rates should be differentiated from missed cancer rates as part of ongoing quality assurance.

Baines CJ. The mammography controversy: full steam ahead versus reasonable caution. AJR Am J Roentgenol 2013 Jan;200(1):W96-7. DOI:10.2214/AJR.12.9362; 10.2214/AJR.12.9362.

Feig SA. Reply. AJR Am J Roentgenol 2013 Jan;200(1):W98-9.PMID:23379023.
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