Point: Mammography Screening—Sticking to the Science

Yaffe, Martin J.

doi:10.3747/co.22.2371

Cited by 8 publications

(8 citation statements)

References 21 publications

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“…Breast cancer screening can reduce mortality by detecting cancers at an earlier stage of disease progression when the likelihood of survival is high. Overall, mortality reductions from the routine use of mammograms have been estimated between 19% and 40% [ 7 ]. As mammography has shown to effectively detect signs of breast cancer before they can be seen or felt, the American Cancer Society (ACS) recommends annual breast cancer screening for women in the age group of 45 and 54 years, as well as biannual or annual screening depending on a patient’s risk for women aged 55 years and older [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial

Lee¹,

Ghebre²,

Le³

et al. 2017

JMIR Mhealth Uhealth

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BackgroundDespite the increasing breast cancer incidence and mortality rates, Korean American immigrant women have one of the lowest rates of breast cancer screening across racial groups in the United States. Mobile health (mHealth), defined as the delivery of health care information or services through mobile communication devices, has been utilized to successfully improve a variety of health outcomes.ObjectiveThis study adapted the principles of mHealth to advance breast cancer prevention efforts among Korean American immigrant women, an underserved community.MethodsUsing a randomized controlled trial design, 120 Korean American women aged 40 to 77 years were recruited and randomly assigned to either the mMammogram intervention group (n=60) to receive culturally and personally tailored multilevel and multimedia messages through a mobile phone app along with health navigator services or the usual care control group (n=60) to receive a printed brochure. Outcome measures included knowledge, attitudes, and beliefs about breast cancer screening, readiness for mammography, and mammogram receipt. The feasibility and acceptability of the mMammogram intervention was also assessed.ResultsThe intervention group showed significantly greater change on scores of knowledge of breast cancer and screening guidelines (P=.01). The intervention group also showed significantly greater readiness for mammography use after the intervention compared with the control group. A significantly higher proportion of women who received the mMammogram intervention (75%, 45/60) completed mammograms by the 6-month follow-up compared with the control group (30%, 18/60; P<.001). In addition, the intervention group rated satisfaction with the intervention (P=.003), effectiveness of the intervention (P<.001), and increase of knowledge on breast cancer and screenings (P=.001) significantly higher than the control group.ConclusionsA mobile phone app–based intervention combined with health navigator service was a feasible, acceptable, and effective intervention mechanism to promote breast cancer screening in Korean American immigrant women. A flexible, easily tailored approach that relies on recent technological advancements can reach underserved and hard-to-recruit populations that bear disproportionate cancer burdens.Trial RegistrationClinicaltrials.gov NCT01972048; https://clinicaltrials.gov/show/NCT01972048 (Archived by WebCite at https://clinicaltrials.gov/archive/NCT01972048/2013_10_29)

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Section: Introductionmentioning

confidence: 99%

Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial

Lee¹,

Ghebre²,

Le³

et al. 2017

JMIR Mhealth Uhealth

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“…The results of the CNBSS suggest that annual screening of women aged 40 to 59 years does not reduce breast cancer mortality beyond that of physical examination or usual care and that, as a result, policy makers should urgently reassess the rationale for mammography screening [1]. While the CNBSS has received considerable methodological criticism [2–5], a recent evaluation report issued by the International Agency for Research on Cancer (IARC) draws similar conclusions. The IARC work group evaluates that while the “efficacy of mammographic screening in reducing mortality from breast cancer is sufficient for women 50 to 69 years; efficacy for women in other age groups is considered inadequate” [6].…”

Section: Introductionmentioning

confidence: 99%

Investigating young women’s motivations to engage in early mammography screening in Switzerland: results of a cross-sectional study

2017

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BackgroundThe scientific and public debate concerning organized mammography screening is unprecedentedly strong. With research evidence concerning its efficacy being ambiguous, the recommendations pertaining to the age-thresholds for program inclusion vary between – and even within – countries. Data shows that young women who are not yet eligible for systematic screening, have opportunistic mammograms relatively often and, moreover, want to be included in organized programs. Yet, to date, little is known about the precise motivations underlying young women’s desire and intentions to go for, not medically indicated, mammographic screening.MethodsA cross-sectional online survey was carried out among women aged 30-49 years (n = 918) from Switzerland.ResultsThe findings show that high fear (β = .08, p ≤ .05), perceived susceptibility (β = .10, p ≤ .05), and ego-involvement (β = .34, p ≤ .001) are the main predictors of screening intentions among women who are not yet eligible for the systematic program. Also, geographical location (Swiss-French group: β = .15, p ≤ .001; Swiss-Italian group: β = .26, p ≤ .001) and age (β = .11, p ≤ .001) play a role. In turn, breast cancer knowledge, risk perceptions, and educational status do not have a significant impact.ConclusionsYoung women seem to differ inherently from those who are already eligible for systematic screening in terms of the factors underlying their intentions to engage in mammographic screening. Thus, when striving to promote adherence to systematic screening guidelines – whether based on unequivocal scientific evidence or policy decisions – and to allow women to make evidence-based, informed decisions about mammography, differential strategies are needed to reach different age-groups.

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“…The latest guideline of the American Cancer Society states that all women should begin having yearly mammograms by age 45, and can change to having mammograms every other year beginning at age 55. Furthermore, women should have the choice to start with yearly mammograms at age 40 if they want to . According to the US Preventive Services Task Force, the decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms .…”

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confidence: 99%

Benefits and harms of breast cancer screening with mammography in women aged 40–49 years: A systematic review

Ende¹,

Oordt-Speets²,

Vroling³

et al. 2017

Intl Journal of Cancer

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Early detection of breast cancer through screening can lower breast cancer mortality rates and reduce the burden of this disease in the population. In most western countries, mammography screening starting from age 50 is recommended. However, there is debate about whether breast cancer screening should be extended to younger women. This systematic review provides an overview of the evidence from RCTs on the benefits and harms of breast cancer screening with mammography in women aged 40-49 years. The quality of the evidence for each outcome was appraised using the GRADE approach. Four articles reporting on two different trials-the Age trial and the Canadian National Breast Screening Study-I (CNBSS-I)-were included. The results showed no significant effect on breast cancer mortality (Age trial: RR 0.93 (95% CI 0.80-1.09); CNBSS-I: HR 1.10 (95% CI 0.86-1.40)) nor on all-cause mortality (RR 0.98, 95% CI 0.93-1.03) in women aged 40-49 years offered screening. Among regularly attending women, the cumulative risk of experiencing a false-positive recall was 20.5%. Over-diagnosis of invasive breast cancer at 5 years post-cessation of screening for women aged 40-49 years was estimated to be 32% and at 20 years post-cessation of screening to be 48%. Including ductal carcinoma in situ, these numbers were 41% and 55%. Based on the current evidence from randomised trials, extending mammography screening to younger age groups cannot be recommended. However, there were limitations including relatively low sensitivity of screening and screening attendance, insufficient power, and contamination, which may explain the nonsignificant results.

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Point: Mammography Screening—Sticking to the Science

Abstract: -

Cited by 8 publications

References 21 publications

Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial

Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial

Investigating young women’s motivations to engage in early mammography screening in Switzerland: results of a cross-sectional study

Benefits and harms of breast cancer screening with mammography in women aged 40–49 years: A systematic review

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