Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years' follow-up: a randomised controlled trial

Moss, Sue; Cuckle, Howard; Evans, Andy; Johns, Louise; Waller, Michael; Bobrow, Lynda G.

doi:10.1016/s0140-6736(06)69834-6

Cited by 428 publications

(249 citation statements)

References 29 publications

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“…Redhwan A Al-Naggar 1 , Yuri V Bobryshev 2 * 2002; Moss et al, 2006), and numerous expert groups recommend periodic mammograms, either annually (American Cancer Society, 2012) or every 1-2 years (National Cancer Institute, 2012;Zogby, 2012) for women aged 40 and older.…”

Section: Practice and Barriers Of Mammography Among Malaysian Women Imentioning

confidence: 99%

Practice and Barriers of Mammography among Malaysian Women in the General Population

Al-Naggar¹,

Bobryshev²

2012

Asian Pacific Journal of Cancer Prevention

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Objective: The objective of this study was to determine the practice and barriers of mammography and associated factors among Malaysian women in the general population. Methodology: A cross-sectional study was conducted among 200 women in Shah Alam, Selangor; Malaysia. The questionnaire contained 27 questions and was comprised of two sections; socio-demographic characteristics and practices, knowledge and barriers of mammography. All the data were analyzed using the Statistical Package for the Social Sciences (SPSS) 13.0. Results: Of the 200 Malaysian women who participated in this study, the majority were under the age of 50 years (65.5%), Malay (86%), and married (94.5%). Regarding any family history of cancer in general, the majority of the participants had none (78%). However, some did report a close relative with breast cancer (16.5%). While the majority of them knew about mammography (68%), 15% had had a mammogram once in their life and only 2% had the procedure every two or three years. Univariate analysis showed that age, family history of cancer, family history of breast cancer, regular supplement intake, regular medical check-up and knowledge about mammogram were significantly associated with mammogram practice among the general population (p=0.007, p=0.043, P=0.015, p=0.01, p=0.001, p<0.001; respectively). Multivariate analysis using multiple linear regression test showed that age, regular medical check-up and knowledge about mammography testing were statistically associated with the practice of mammography among the general population in Malaysia (p=0.035, p=0.015 and p<0.001; respectively). Lack of time, lack of knowledge, not knowing where to go for the test and a fear of the test result were the most important barriers (42.5%, 32%, 21%, 20%; respectively). Conclusion: The practice of mammogram screening is low among Malaysian women.

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Section: Practice and Barriers Of Mammography Among Malaysian Women Imentioning

confidence: 99%

Practice and Barriers of Mammography among Malaysian Women in the General Population

Al-Naggar¹,

Bobryshev²

2012

Asian Pacific Journal of Cancer Prevention

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“…[2][3][4] Furthermore, Otto et al 5,6 showed that the Dutch population-based screening programme is effective in reducing breast cancer mortality. The evidence for the benefit of mammography screening for younger women is less conclusive, [7][8][9] however, an effect for this age group is supported by several studies. Although the UK Age Trial showed a non-significant 17% reduction in breast cancer mortality, 9 a statistically significant breast cancer mortality reduction of 15% to 18% associated with screening for women aged 39 to 49 or 40 to 49 at entry was demonstrated by several meta-analyses of randomised controlled trials.…”

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confidence: 99%

Cost‐effectiveness of digital mammography screening before the age of 50 in The Netherlands

Sankatsing

Heijnsdijk

Luijt

et al. 2015

Intl Journal of Cancer

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In the Netherlands, routine mammography screening starts at age 50. This starting age may have to be reconsidered because of the increasing breast cancer incidence among women aged 40 to 49 and the recent implementation of digital mammography. We assessed the cost-effectiveness of digital mammography screening that starts between age 40 and 49, using a microsimulation model. Women were screened before age 50, in addition to the current programme (biennial 50-74). Screening strategies varied in starting age (between 40 and 50) and frequency (annual or biennial). The numbers of breast cancers diagnosed, life-years gained (LYG) and breast cancer deaths averted were predicted and incremental cost-effectiveness ratios (ICERs) were calculated to compare screening scenarios. Biennial screening from age 50 to 74 (current strategy) was estimated to gain 157 life years per 1,000 women with lifelong follow-up, compared to a situation without screening, and cost e3,376/ LYG (3.5% discounted). Additional screening increased the number of LYG, compared to no screening, ranging from 168 to 242. The costs to generate one additional LYG (i.e., ICER), comparing a screening strategy to the less intensive alternative, were estimated at e5,329 (biennial 48-74 vs. current strategy), e7,628 (biennial 45-74 vs. biennial 48-74), e10,826 (biennial 40-74 vs. biennial 45-74) and e18,759 (annual 40-49 1 biennial 50-74 vs. biennial 40-74). Other strategies (49 1 biennial 50-74 and annual 45-49 1 biennial 50-74) resulted in less favourable ICERs. These findings show that extending the Dutch screening programme by screening between age 40 and 49 is cost-effective, particularly for biennial strategies.Breast cancer is the most commonly diagnosed form of cancer among women aged 30 and older in the Netherlands. 1 Mammography screening allows for early detection and early treatment of breast cancer, with the aim of averting breast cancer death. In the Netherlands, women aged 50 to 74 are invited biennially to screening. Various randomised controlled trials demonstrated a statistically significant breast cancer mortality reduction due to mammography screening in this age group. 2-4 Furthermore, Otto et al. 5,6 showed that the Dutch population-based screening programme is effective in reducing breast cancer mortality. The evidence for the benefit of mammography screening for younger women is less conclusive, 7-9 however, an effect for this age group is supported by several studies. Although the UK Age Trial showed a non-significant 17% reduction in breast cancer mortality, 9 a statistically significant breast cancer mortality reduction of 15% to 18% associated with screening for women aged 39 to 49 or 40 to 49 at entry was demonstrated by several meta-analyses of randomised controlled trials. [10][11][12][13] In addition, a recent Swedish observational study that compared breast cancer mortality rates between women aged 40 and 49 who were invited to screening and women who were not invited to screening demonstrated a 26% statistically significant br...

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“…The mortality benefit for women in the general population aged 40-49 years is likely to be smaller 2,3 : in the UK population, after 10-year follow-up, a nonsignificant 17% reduction in breast cancer mortality was observed in women invited aged 39-41 to receive annual mammography compared to those not invited. 4 In addition, due to lower incidence in this age group, the mortality benefit is characterised by fewer lives saved in return for the financial and human costs. 5 There is evidence that targeted screening in women aged 40-49 at intermediate familial risk might be a reasonable approach.…”

mentioning

confidence: 99%

A case‐control study to assess the impact of mammographic density on breast cancer risk in women aged 40–49 at intermediate familial risk

Assi

Massat

Thomas

et al. 2014

Intl Journal of Cancer

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Mammographic density is a strong risk factor for breast cancer, but its potential application in risk management is not clear, partly due to uncertainties about its interaction with other breast cancer risk factors. We aimed to quantify the impact of mammographic density on breast cancer risk in women aged 40-49 at intermediate familial risk of breast cancer (average lifetime risk of 23%), in particular in premenopausal women, and to investigate its relationship with other breast cancer risk factors in this population. We present the results from a case-control study nested with the FH01 cohort study of 6,710 women mostly aged 40-49 at intermediate familial risk of breast cancer. One hundred and three cases of breast cancer were agematched to one or two controls. Density was measured by semiautomated interactive thresholding. Absolute density, but not percent density, was a significant risk factor for breast cancer in this population after adjusting for area of nondense tissue (OR per 10 cm 2 5 1.07, 95% CI 1.00-1.15, p 5 0.04). The effect was stronger in premenopausal women, who made up the majority of the study population. Absolute density remained a significant predictor of breast cancer risk after adjusting for age at menarche, age at first live birth, parity, past or present hormone replacement therapy, and the Tyrer-Cuzick 10-year relative risk estimate of breast cancer. Absolute density can improve breast cancer risk stratification and delineation of high-risk groups alongside the Tyrer-Cuzick 10-year relative risk estimate.

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Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years' follow-up: a randomised controlled trial

Cited by 428 publications

References 29 publications

Practice and Barriers of Mammography among Malaysian Women in the General Population

Practice and Barriers of Mammography among Malaysian Women in the General Population

Cost‐effectiveness of digital mammography screening before the age of 50 in The Netherlands

A case‐control study to assess the impact of mammographic density on breast cancer risk in women aged 40–49 at intermediate familial risk

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