programas cribado cancer


Nota Bibliográfica

Esta Nota es una recopilación de publicaciones (artículos, informes, libros) sobre cribado de cáncer resultado de una revisión no sistemática de la literatura.

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Josep A Espinás. Pla Director d'Oncología de Catalunya.
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Nota bibliográfica cribado c mama 2013-03

Correspondencia artículo:  Independent UK Panel on Breast Cancer Screening. The benefits and harms of breast cancer screening: an independent review.  Lancet, 380 (2012), pp. 1778–1786:

Autier P, Boniol M, Boyle P. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):800. DOI:10.1016/S0140-6736(13)60620-0.

Bird SM. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):802-803. DOI:10.1016/S0140-6736(13)60625-X.

Donzelli A. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):799-800. DOI:10.1016/S0140-6736(13)60619-4.

Duffy SW. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):802. DOI:10.1016/S0140-6736(13)60624-8.

Gøtzsche PC, Jørgensen KJ. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):799. DOI:10.1016/S0140-6736(13)60618-2.

Hanley JA, Liu Z, McGregor M. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):800. DOI:10.1016/S0140-6736(13)60621-2.

Paci E, Broeders M, Hofvind S, Duffy SW. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):800-801. DOI:10.1016/S0140-6736(13)60622-4.

Zahl P. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):801-802. DOI:10.1016/S0140-6736(13)60623-6.

Mühlhauser I. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):803. DOI:10.1016/S0140-6736(13)60626-1.

Jatoi I. The benefits and harms of breast cancer screening. The Lancet 2013 3/9–15;381(9869):803. DOI:10.1016/S0140-6736(13)60627-3.

The benefits and harms of breast cancer screening – Authors' reply. (carta). The Lancet 2013 3/9–15;381(9869):803-804. DOI:10.1016/S0140-6736(13)60628-5

Duffy S, Mackay J, Thomas S, Anderson E, Chen T, Ellis I, et al. Evaluation of mammographic surveillance services in women aged 40-49 years with a moderate family history of breast cancer: a single-arm cohort study. Health Technol Assess 2013 Mar;17(11):1-95. DOI:10.3310/hta17110; 10.3310/hta17110. PMID:23489892.

CONCLUSIONS: Annual mammography in women aged 40-49 years with a significant family history of breast or ovarian cancer is both clinically effective in reducing breast cancer mortality and cost-effective. There is a need to further standardise familial risk assessment, to research the impact of digital mammography and to clarify the role of breast density in this population.


Nota bibliográfica cribado c mama 2013-02

Braithwaite D, Zhu W, Hubbard RA, O’Meara ES, Miglioretti DL, Geller B, et al. Screening Outcomes in Older US Women Undergoing Multiple Mammograms in Community Practice: Does Interval, Age or Comorbidity Score Affect Tumor Characteristics or False Positive Rates? Journal of the National Cancer Institute 2013 February 05 DOI:10.1093/jnci/djs645.

Conclusion Women aged 66 to 89 years who undergo biennial screening mammography have similar risk of advanced-stage disease and lower cumulative risk of a false-positive recommendation than annual screeners, regardless of comorbidity.

 Schou Bredal I, Kåresen R, Skaane P, Engelstad KS, Ekeberg Ø. Recall mammography and psychological distress. Eur J Cancer 2013 3;49(4):805-811. DOI:10.1016/j.ejca.2012.09.001.

Concluding statement Recall after mammography was associated with transiently increased anxiety. Four weeks after screening, the level of anxiety was the same and depression was lower compared with the general female Norwegian population. The women were almost unanimously satisfied with their participation in the screening, would participate again and would recommend other women to participate.

 Autier P, Boniol M, Jorgensen KJ, Lannin D,R, Monticciolo D, Monsees B, et al. Effect of Screening Mammography on Breast Cancer Incidence. (carta). N Engl J Med 2013 02/14; 2013/02;368(7):677-679. DOI:10.1056/NEJMc1215494. Enlace:

 Feig SA. Reply. (carta). Am J Roentgenol 2013 01/01; 2013/03;200(1):W98-W100. DOI:10.2214/AJR.12.9922. Enlace:


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.


Nota bibliográfica cribado c mama 2012-12

Mette Kalager, Rulla M Tamimi, Michael Bretthauer, Hans-Olov Adami. Prognosis in women with interval breast cancer: population based observational cohort study. BMJ 2012;345  DOI:10.1136/bmj.e7536.  

Conclusion The prognosis of women with interval breast cancers was the same as that of women with breast cancers diagnosed without mammography screening.


Nota bilbiografia cribado c mama 2012-11

Bretthauer M, Kalager M. Principles, effectiveness and caveats in screening for cancer. Br J Surg 2013;100(1):55-65. DOI:10.1002/bjs.8995.
Conclusion: Cancer screening has been established for several cancer forms in Europe. The potential for incidence and mortality reduction is good, but harms do exist that need to be addressed, and communicated to the public.

Mammography Screening for Breast Cancer. N Engl J Med 2012 11/22; 2012/11;367(21):e31. DOI:10.1056/NEJMclde1212888. Enlace:

Olsen AH, Lynge E, Njor SH, Kumle M, Waaseth M, Braaten T, et al. Breast cancer mortality in Norway after the introduction of mammography screening. International Journal of Cancer 2013;132(1):208-214. DOI:10.1002/ijc.27609.

In Norway, where 40% of women used regular mammography prior to the program, the implementation of the organized mammography screening program was associated with a statistically nonsignificant decrease in breast cancer mortality of around 11%.

Melús Palazón E, Coscollar Santaliestra C, Bartolomé Moreno C. Mamografía: ¿es incorrecto decir no? FMC - Formación Médica Continuada en Atención Primaria 2012 0;19(7):389-391. DOI:10.1016/S1134-2072(12)70420-6.

Timmers JM, den Heeten GJ, Adang EM, Otten JD, Verbeek AL, Broeders MJ. Dutch digital breast cancer screening: implications for breast cancer care. The European Journal of Public Health 2012 December 01;22(6):925-929. DOI:10.1093/eurpub/ckr170.

Conclusion: Our study shows that a low referral rate in combination with the introduction of digital mammography affects the balance between referral rate and detection rate and can substantially influence breast cancer care and associated costs. Referral rates in the Netherlands are now more comparable to other countries. This effect is therefore of value in countries where implementation of digital breast cancer screening has just started or is still under discussion.

Bleyer A, Welch HG. Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence. N Engl J Med 2012 11/22; 2012/11;367(21):1998-2005. DOI:10.1056/NEJMoa1206809.


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