Understanding breast cancer screening—past, present, and future

Sitt, Jcm; Lui, CY; Sinn, Lutz; Fong, July

doi:10.12809/hkmj177123

Cited by 17 publications

(15 citation statements)

References 42 publications

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“…Recommendations and controversies on the benefits and downsides of prevention and screening strategy have been brought to the public's attention with regard to cervical cancer, 7 colorectal cancer, 8 and breast cancer. [9][10][11][12] At present, the cervical screening programme and the colorectal cancer screening programme are the two territory-wide strategies regularised in Hong Kong based on current evidence. 1 It is recommended that Hong Kong individuals aged 50 to 75 years with average risk for colorectal cancer should consult their physicians to consider either one of the three screening modalities (faecal occult blood test, sigmoidoscopy, or colonoscopy) at different screening intervals.…”

Section: Implications Of Evidence-based Understanding Of Benefits Andmentioning

confidence: 99%

Implications of evidence-based understanding of benefits and risks for cancer prevention strategy

Wang

2019

Hong Kong Med J

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Section: Implications Of Evidence-based Understanding Of Benefits Andmentioning

confidence: 99%

Implications of evidence-based understanding of benefits and risks for cancer prevention strategy

Wang

2019

Hong Kong Med J

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“…The continent of Asia has relatively lower the number of breast cancer deaths compared to the rest of the world [7]. However, upper-middle income Asian countries such as Malaysia and Taiwan initiated population-based mammographic screening (since 2004) considering the rising incidence and death rates due to breast cancer in those countries [8]. Japan began clinical breast examination in 1987, followed by recommendations to use mammography in combination with clinical breast examination as a populationbased program in the year 2000 [9].…”

Section: History Of Screening Mammography: How Different Countries Ofmentioning

confidence: 99%

“…They also declared that breast cancer mortality was a biased factor towards mammographic screening. The review was heavily condemned by many as the reviewers discarded the majority of the randomized control trials available at the time, stating that the excluded studies were inadequately randomized but ignoring flaws in the two studies with no mortality benefits of mammography and for using cancer registry data instead of patient records (8). Furthermore, the Cochrane review considered a total number of invited women for breast cancer screening to be the participant numbers, which could generate inconclusive evidence on overdiagnosis rate.…”

Section: Debates and Recent Controversies On Mammographic Breast Scrementioning

confidence: 99%

Evidence based mammography screening: is evidence changing?

Liyanage

Samaranayake

2019

Sri Lanka j Surg

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Population-based mammography screening programmes were launched by developed countries in the latter half of the twentieth century based on the promising evidence on mortality benefits reported by the earliest randomised control trials (RCTs). It was widely accepted that screening mammography significantly reduced breast cancer mortality in women invited for screening. However, since the first RCT in the 1960s, varying evidence has been tabled by many researchers, sometimes alarming the public, drawing attention to the harms of screening mammography, mainly identified as overdiagnosis and false positives. While overtreatment is recognised as a consequence of over diagnosis, a relatively newer set of harms categorized under psychological distress have been highlighted as resultant from false positive screening tests. Currently, the magnitude of the harms of screening mammography remains uncertain. The most turbulent reviews on breast screening, however, were the queries into the well and long believed mortality benefits of mammography screening first tabled in the 1970s by the Canadian national breast screening study. A Cochrane review by Gøtzsche and Jørgensen further added to the negative attributes of mammography screening as they concluded that the actual current mortality benefits are nonsignificant and smaller than that claimed by many RCTs which were poorly randomised. Although heavily criticized, sparks ignited by these reports have led many countries worldwide to conduct their panel discussions on evidence on population screening mammography. While many countries have decided to continue their programmes understanding the harms involved, Switzerland in this light has discontinued their population-based mammography screening programme. The debate continues; currently while not overlooking the mortality benefits of mammography, it is also understood that the mortality benefits are not solely due to mammography but are also contributed by other factors such as advancement in Correspondence: U.A. Liyanage

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“…To the Editor-Whilst the emphasis on shared decision making in breast screening of Sitt et al 1 is warmly welcomed, one struggles to visualise how this can be promoted when their overview could arguably be condensed into three major take-home messages: (1) any study critical of screening is 'controversial'; (2) risks of screening are overstated; and (3) harms of not screening are overestimated.…”

Section: Breast Screening Controversy and The 'Mammography Wars'-two mentioning

confidence: 99%

Breast screening controversy and the ‘mammography wars’—two sides to every story

2018

Hong Kong Med J

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Understanding breast cancer screening—past, present, and future

Cited by 17 publications

References 42 publications

Implications of evidence-based understanding of benefits and risks for cancer prevention strategy

Implications of evidence-based understanding of benefits and risks for cancer prevention strategy

Evidence based mammography screening: is evidence changing?

Breast screening controversy and the ‘mammography wars’—two sides to every story

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