Breast cancer screening reduces risk of death

Breast cancer screening reduces risk of death

Overall, women who are invited to attend mammography screening have a 23% risk reduction in breast cancer death (owing to some attending and some not), compared with women not invited by routine screening programmes.

In the UK, this relative risk translates to around eight deaths prevented per 1,000 women regularly attending screening, and five deaths prevented per 1,000 women invited to screening.

Experts from 16 countries assessed the positive and negative impact of different breast cancer screening methods, based on a comprehensive analysis of evidence from 11 randomised controlled trials and 40 high-quality observational studies for the study. As the study looked at breast cancer screening on a global level, data on routine screening programmes (where all women of a certain age are invited to attend) and opportunistic screening services (which operate in countries without a set programme) were assessed.

The study was co-ordinated by the International Agency for Research in Cancer (IARC), the World Health Organisation's specialised cancer agency, and its findings will contribute to an update of the IARC Handbook on breast cancer screening, last published in 2002.

Stephen Duffy, Professor of Cancer Screening at Queen Mary University of London, who was involved with the study, said: "This important analysis will hopefully reassure women around the world that breast screening with mammography saves lives. The evidence proves breast screening is a vital tool in increasing early diagnosis of breast cancer and therefore reducing the number of deaths.

"In the UK we are extremely fortunate to have the NHS Breast Screening Programme where all women aged 50-70 years are invited to attend. Women invited to this service can be reassured the programme is endorsed by internationally respected organisations and experts."

The report confirms previous findings that women aged 50-69 years benefit most from breast cancer screening. However, several studies also showed a substantial reduction in risk of death from breast cancer by inviting women aged 70-74 years for screening - a shift away from previous consensus. Only limited evidence was identified in favour of screening women in their 40s.

Professor Duffy continues: "Despite evidence that mammography screening is effective, we still need to carry out further research on alternative screening methods, such as the promising 'digital breast tomosynthesis'; a newly developed form of 3D imaging which could potentially improve the accuracy of mammography in coping with more dense breast tissue.

"It is also vital we continue researching the most effective ways of screening women at high risk of breast cancer due to family history or genetic status. We need further evidence to fine-tune services offered to high-risk women in terms of different screening methods, from an earlier age and possibly at shorter intervals."


* Béatrice Lauby-Secretan, et al. Breast-Cancer Screening — Viewpoint of the IARC Working Group. New England Journal of Medicine, June 2015. 





By Ingrid Torjesen,

OnMedica Thursday 04 June 2015

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