programas cribado cancer

Nota bibliográfica cribado c mama 2014-09

Natal C, Caicoya M, Prieto M, Tardón A. Incidencia de cáncer de mama en relación con la participación en un programa de cribado poblacional. Med Clin (Barc). 2014;(x). Available from: doi: 10.1016/j.medcli.2014.04.028.

Ascunce N. Sobrediagnóstico en programas de cribado de cáncer de mama: un efecto adverso inevitable que debe tenerse en cuenta. Med Clin (Barc). 2014;(x). Available from: doi: 10.1016/j.medcli.2014.07.017. PMID: 25178546.

Heinävaara S, Sarkeala T, Anttila A. Overdiagnosis due to breast cancer screening: updated estimates of the Helsinki service study in Finland. Br J Cancer. 2014;111(7):1463–8. Available from: doi: 10.1038/bjc.2014.413. PMID: 25121953.

Conclusions:Our estimates of overdiagnosis are of the same magnitude than other plausible estimates in Europe. Both alternative approaches produced similar estimates for the expected cumulative incidence, which increased the confidence in the estimates of overdiagnosis.

Overdiagnosis from mammographic screening. Position Statment. 2014.
Summary Cancer Australia supports the importance of mammographic screening in reducing breast cancer mortality. The national BreastScreen Australia Evaluation indicated a reduction in breast cancer mortality for the age group of 50-69 years of approximately 21-28% at the participation level of 56%. Participation in the BreastScreen Australia Program would result in around 8 deaths prevented for every 1000 women screened every two years from age 50 to age 74. A majority of breast cancers found through screening would be progressive and would become symptomatic within a woman’s lifetime if left untreated. It is likely that some screen-detected breast cancers (ductal carcinoma in situ or invasive breast cancer) might never have progressed to become symptomatic in a woman’s lifetime. Detection of these cancers is sometimes referred to as “overdiagnosis”. It is not possible to precisely predict at diagnosis, to which cancers overdiagnosis would apply. Estimates of overdiagnosis vary widely. Based on UK and European reviews, it is estimated that for every 1000 women in Australia who are screened every two years from age 50 to age 74, around 8 (between 2 and 21) breast cancers may be found and treated that would not have been found in a woman’s lifetime. Research is needed, including molecular and genomic research, to find means of identifying cancers that would be of minimal risk of progression and therefore could be managed more conservatively.

Bell RJ. Screening mammography - early detection or over-diagnosis? Contribution from Australian data. Climacteric. 2014;1–7. Available from: doi: 10.3109/13697137.2014.956718. PMID: 25224048.

Conclusions The benefits and harms of screening mammography are finely balanced. The impact of screening mammography is at best neutral but may result in overall harm. Women should be informed of the issue of over-diagnosis. It is time to review whether organized mammographic screening programs should continue.

Waller J, Whitaker KL, Winstanley K, Power E, Wardle J. A survey study of women’s responses to information about overdiagnosis in breast cancer screening in Britain. Br J Cancer. 2014;(August):1–5. Available from: doi: 10.1038/bjc.2014.482. PMID: 25167224.

Conclusions:Brief written information on overdiagnosis was incompletely understood, but reduced breast screening intentions in a proportion of women, regardless of comprehension. Subjective comprehension was lower among women who had not yet reached screening age but the deterrent effect was higher.British Journal of Cancer advance online publication, 28 August 2014; doi:10.1038/bjc.2014.482

Munoz D, Near AM, van Ravesteyn NT, Lee SJ, Schechter CB, Alagoz O, et al. Effects of Screening and Systemic Adjuvant Therapy on ER-Specific US Breast Cancer Mortality. J Natl Cancer Inst. 2014;106(11). Available from: doi: 10.1093/jnci/dju289.

Conclusion As advances in risk assessment facilitate identification of women with increased risk of ER-negative breast cancer, additional mortality reductions could be realized through more frequent targeted screening, provided these benefits are balanced against screening harms.

Coldman A, Phillips N, Wilson C, Decker K, Chiarelli AM, Brisson J, et al. Pan-Canadian Study of Mammography Screening and Mortality from Breast Cancer. J Natl Cancer Inst. 2014;106(11). Available from: doi: 10.1093/jnci/dju261.

Conclusion Participation in mammography screening programs in Canada was associated with substantially reduced breast cancer mortality
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