Mandrik, O., Zielonke, N., Meheus, F. et al. (4 more authors) (2019) Systematic reviews as a “lens of evidence”: determinants of benefits and harms of breast cancer screening. International Journal of Cancer, 145 (4). pp. 994-1006. ISSN 0020-7136
Abstract
This systematic review, stimulated by inconsistency in secondary evidence, reports the benefits and harms of breast cancer (BC) screening and their determinants according to systematic reviews. A systematic search, which identified 9,976 abstracts, led to the inclusion of 58 reviews. BC mortality reduction with screening mammography was 15–25% in trials and 28–56% in observational studies in all age groups, and the risk of stage III+ cancers was reduced for women older than 49 years. Overdiagnosis due to mammography was 1–60% in trials and 1–12% in studies with a low risk of bias, and cumulative false‐positive rates were lower with biennial than annual screening (3–17% vs 0.01–41%). There is no consistency in the reviews’ conclusions about the magnitude of BC mortality reduction among women younger than 50 years or older than 69 years, or determinants of benefits and harms of mammography, including the type of mammography (digital vs screen‐film), the number of views, and the screening interval. Similarly, there was no solid evidence on determinants of benefits and harms or BC mortality reduction with screening by ultrasonography or clinical breast examination (sensitivity ranges, 54–84% and 47–69%, respectively), and strong evidence of unfavourable benefit‐to‐harm ratio with breast self‐examination. The reviews’ conclusions were not dependent on the quality of the reviews or publication date. Systematic reviews on mammography screening, mainly from high‐income countries, systematically disagree on the interpretation of the benefit‐to‐harm ratio. Future reviews are unlikely to clarify the discrepancies unless new original studies are published.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2019 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
Dates: |
|
Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 12 Feb 2019 10:04 |
Last Modified: | 05 Aug 2019 15:44 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1002/IJC.32211 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:142207 |
Download
Filename: Mandrik_et_al-2019-International_Journal_of_Cancer.pdf
Licence: CC-BY-NC-ND 4.0