FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W3152245004> ?p ?o ?g. }

• W3152245004 endingPage "549" @default.
• W3152245004 startingPage "548" @default.
• W3152245004 abstract "HomeRadiologyVol. 299, No. 3 PreviousNext Reviews and CommentaryFree AccessEditorialInfluence of Patient Participation on Decreased Mortality from Screening MammographyStephen A. Feig Stephen A. Feig Author AffiliationsFrom the Department of Radiology, University of California, Irvine Medical Center, 101 City Drive South, Route 140, Orange, CA 92868-3298.Address correspondence to the author (e-mail: [email protected]).Stephen A. Feig Published Online:Mar 30 2021https://doi.org/10.1148/radiol.2021210226MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In See also the article by Duffy and Tabár et al in this issue.Dr Feig is professor and division chief of breast imaging at University of California Irvine. His research interests include calculation of benefits, cost-effectiveness, and hypothetical risks from screening and development of multimodality screening guidelines. He has been awarded the gold medal from the Society of Breast Imaging.Download as PowerPointOpen in Image Viewer The Swedish Nine-County Service Screening Study (from 1992 to 2016) (1) was a public health measure performed after the success of the Swedish Two-County Randomized Clinical Trial (RCT) of mammography screening. RCTs such as the Two-County Trial (from 1978 to 1987) had to be performed first to provide proof that screening can reduce breast cancer mortality (2).Randomized trials consist of study and control groups. The two groups are carefully matched in every possible way, except the study group is offered screening and the control group is not. To avoid bias, RCTs measure breast cancer death rates rather than survival or incidence rates. Furthermore, RCTs are designed to avoid lead-time bias, length bias sampling, and selection bias. Lead-time bias refers to the possibility that screening finds breast cancers earlier but does not alter the time of death. Length bias sampling postulates that some cancers detected at screening are slower growing, less aggressive, and may never cause death if undetected. Selection bias refers to the possibility that women who volunteer for screening may have better health or better socioeconomic status than those who do not volunteer. Finally, faster growth rates for interval cancers missed at screening may negate more favorable survival rates for screen-detected cancers. The use of breast cancer mortality rates in a well-designed randomized trial avoids all these potential biases.Despite these advantages, RCTs may underestimate the true benefit from screening for two reasons: (a) some women in the study group may not agree to undergo screening (noncompliance) and (b) some women in the control group may obtain screening on their own, outside of the trial (contamination). Thirty-year follow-up of the Swedish Two-County Trial now shows a 31% mortality reduction among women aged 40–74 years in the study group offered screening compared with the control group not offered screening (3). However, even such long-term follow-up may underestimate the potential benefit from screening mammography (2).In this issue of Radiology, Duffy and colleagues (4) use data from the Swedish Nine-County Service Screening Study to estimate the potential benefit based on a woman’s participation in the last two screening rounds (1,4). In the study by Duffy et al, women aged 40–54 years could undergo screening as often as every 18 months, whereas those aged 55–69 years could undergo screening as often as every 24 months. These women were classified according to their participation in their last two potential screening rounds. Serial participants participated in both of the last two screening rounds. Intermittent participants attended the last but not the next to last screening round. Lapsed participants attended the next to last but not the last screening round. Serial nonparticipants did not attend either of the last two screening rounds.The women in the Swedish Nine-County Service Screening Study were followed for 10 years. For each of the four types of participation categories, the incidence rates per 100 000 person-years of cancers proving fatal within 10 years after diagnosis were measured. The relative risk (RR) was calculated according to participation status. Relative risk was lowest (0.50) for serial participants and highest (1.00) for nonparticipants. Intermittent participants and lapsed participants had relative risks of 0.64 and 0.75, respectively. The estimated 50% mortality reduction observed among serial participants who were actually screened was substantially higher than the 31% mortality reduction observed among study group women in the Swedish Two-County Trial who were offered screening but who may not have participated (3). Thus, the Swedish Nine-County Service Screening Study probably provides a more accurate index of the benefit to women who are actually screened. The cumulative mortality curves of the Swedish Two-County Randomized Trial 30-year follow-up and the Swedish Nine-County Service Screening study 24-year follow-up both diverge from their inception over time. It is clear that both of these studies indicate a substantial long-term benefit from screening.Because randomized trials compare breast cancer deaths between carefully matched study group women who are offered screening and control group women who are not offered screening, these trials are not affected by any bias due to confounding factors, such as socioeconomic status or comorbidities.Adjustments must be made for self-selection bias in the relative risks associated with each of the serial, intermittent, and lapsed participation categories in the Swedish Nine-County Service Screening Trial. Duffy and colleagues used their own method and made adjustments in the relative risks of dying from cancer in these participation categories, which indicate a relative risk of 1.07 for breast cancer deaths unrelated to the screening process (3). Furthermore, an adjustment of 1.03 was made for cancers that were fatal within 10 years of diagnosis in Northern Sweden using the estimate of Jonsson et al (4). Duffy et al discuss the rationale and methods used for this adjustment in their article. All these adjustments were extremely small and do not affect the basic conclusion of the study that compliance with screening recommendations has a major impact on mortality reduction.Eight randomized trials were conducted in Europe and North America between 1963 and 2005 (2,3,5). Mortality reduction for seven of these trials ranged from 17% to 31%. The Canadian National Breast Cancer Screening Study showed no benefit due to issues with technical quality and randomization (6). There are reasons why all these trials underestimated the benefit from screening by today’s standards. These include improvements in technical quality due to digital mammography and digital tomosynthesis. Many of these trials used one mammographic view instead of two for some screening rounds. Many screening intervals were too long. Screening frequency ranged from 12 to 33 months. Estimates show that greater benefit would have resulted from annual screening, especially for women aged 40–49 years who have faster breast cancer growth. Michaelson et al (7) used a tumor growth rate model to calculate that annual screening would result in a 51% reduction in distant metastatic disease compared with a 22% reduction with a screening interval of 2 years.Estimates indicate that the use of annual screening for the Swedish Two-County Trial could have resulted in an additional 18% mortality reduction for women aged 40–49 years who underwent screening every 2 years and an additional 12% mortality reduction in women aged 50–59 years who underwent screening every 33 months (8).Several investigators have used mathematic models of actual RCT data to calculate benefit for an average woman screened every year and for whom results are not affected by noncompliance or contamination. For example, on the basis of an observed 45% reduction in breast cancer mortality among women aged 39–49 years offered screening every 18 months in the Gothenburg Trial, Feig (9) calculated that the mortality reduction could have been even higher. With 85% compliance, it could have been as high as 65% with annual screening. For 100% compliance, it could have been as high as 75% with annual screening.Screening frequency and length of follow-up should be sufficient to reach a steady state at which the greatest mortality reduction will be apparent. Miettinen et al (10) showed that for women aged 55–69 years at entry into the Malmo Mammographic Screening Trial, mortality reduction was highest between 8 and 11 years of follow-up. For that period, they calculated a 55% reduction in breast cancer deaths. That value was much higher than the 26% mortality reduction reported by Andersson and Nystrom, who included data from before year 8 when the benefit had not yet peaked and from after year 11 when the benefit was being diluted (10).Finally, a study of women aged 40–69 years enrolled in two of the Swedish service screening programs between 1988 and 1996 showed a 63% reduction in death rates from breast cancer among screened women and a 48% reduction among those invited to screening (2). A meta-analysis of seven European service screening studies found a breast cancer mortality reduction of 25% among those invited versus those not invited to screening and a reduction of 38% among those screened versus not screened (2). Among the women enrolled in the seven European case-controlled service screening studies, there was a 31% mortality reduction among invited women versus not invited women and a 52% mortality reduction among those who underwent screening versus those who did not undergo screening (2).Results from these many service screening studies indicate that when women fully participate, non–research-organized service screening studies can obtain and exceed the reductions in breast cancer mortality found in randomized trials. Further advances in mammographic technology and optimizations in screening frequency and length will allow even greater benefits.Disclosures of Conflicts of Interest: S.A.F. disclosed no relevant relationships.References1. Duffy SW, Tabár L, Yen AM, et al. Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549 091 women. Cancer 2020;126(13):2971–2979. Crossref, Medline, Google Scholar2. Feig SA. Screening mammography benefit controversies: sorting the evidence. Radiol Clin North Am 2014;52(3):455–480. Crossref, Medline, Google Scholar3. Tabár L, Vitak B, Chen THH, et al. Swedish two-county trial: impact of mammographic screening on breast cancer mortality during 3 decades. Radiology 2011;260(3):658–663. Link, Google Scholar4. Duffy SW, Tabár L, Yen AM, et al. Beneficial Effect of Consecutive Screening Mammography Examinations on Mortality from Breast Cancer: A Prospective Study. Radiology 2021. https://doi.org/10.1148/radiol.2021203935. Published online March 2, 2021. Google Scholar5. Duffy SW, Vulkan D, Cuckle H, et al. Effect of mammographic screening from age 40 years on breast cancer mortality (UK Age trial): final results of a randomised, controlled trial. Lancet Oncol 2020;21(9):1165–1172. Crossref, Medline, Google Scholar6. Kopans DB, Feig SA. The Canadian National Breast Screening Study: a critical review. AJR Am J Roentgenol 1993;161(4):755–760. Crossref, Medline, Google Scholar7. Michaelson JS, Halpern E, Kopans DB. Breast cancer: computer simulation method for estimating optimal intervals for screening. Radiology 1999;212(2):551–560. Link, Google Scholar8. Feig SA. Estimation of currently attainable benefit from mammographic screening of women aged 40-49 years. Cancer 1995;75(10):2412–2419. Crossref, Medline, Google Scholar9. Feig SA. Increased benefit from shorter screening mammography intervals for women ages 40-49 years. Cancer 1997;80(11):2035–2039. Crossref, Medline, Google Scholar10. Miettinen OS, Henschke CI, Pasmantier MW, Smith JP, Libby DM, Yankelevitz DF. Mammographic screening: no reliable supporting evidence?. Lancet 2002;359(9304):404–405. Crossref, Medline, Google ScholarArticle HistoryReceived: Jan 25 2021Revision requested: Feb 5 2021Revision received: Feb 22 2021Accepted: Mar 2 2021Published online: Mar 30 2021Published in print: June 2021 FiguresReferencesRelatedDetailsAccompanying This ArticleBeneficial Effect of Consecutive Screening Mammography Examinations on Mortality from Breast Cancer: A Prospective StudyMar 2 2021RadiologyRecommended Articles Breast Cancer Risk Prediction Using Deep LearningRadiology2021Volume: 301Issue: 3pp. 559-560Identifying Effective Supplemental Screening Strategies for Women with a Personal History of Breast CancerRadiology2020Volume: 295Issue: 1pp. 64-65Addressing Racial Inequities in Access to State-of-the-Art Breast ImagingRadiology2022Volume: 306Issue: 2Comparative Benefit-to–Radiation Risk Ratio of Molecular Breast Imaging, Two-Dimensional Full-Field Digital Mammography with and without Tomosynthesis, and Synthetic Mammography with TomosynthesisRadiology: Imaging Cancer2019Volume: 1Issue: 1Does Reader Performance with Digital Breast Tomosynthesis Vary according to Experience with Two-dimensional Mammography?Radiology2017Volume: 283Issue: 2pp. 371-380See More RSNA Education Exhibits High Risk Breast Cancer Screening  Digital Posters2020Let’s Talk about Next-Generation Breast Cancer Screening Programs: How Should We Do? What Should We Use?Digital Posters2020Breast Imaging Controversies In The Elderly PopulationDigital Posters2021 RSNA Case Collection Deodorant ArtifactRSNA Case Collection2021Slow-growing cancerRSNA Case Collection2020Invasive Lobular CarcinomaRSNA Case Collection2021 Vol. 299, No. 3 Metrics Altmetric Score PDF download" @default.
• W3152245004 created "2021-04-13" @default.
• W3152245004 creator A5059528446 @default.
• W3152245004 date "2021-06-01" @default.
• W3152245004 modified "2023-09-23" @default.
• W3152245004 title "Influence of Patient Participation on Decreased Mortality from Screening Mammography" @default.
• W3152245004 cites W1985476039 @default.
• W3152245004 cites W2020840042 @default.
• W3152245004 cites W2087980435 @default.
• W3152245004 cites W2098699875 @default.
• W3152245004 cites W2126349180 @default.
• W3152245004 cites W2148660398 @default.
• W3152245004 cites W3020983734 @default.
• W3152245004 cites W3048659619 @default.
• W3152245004 cites W99188081 @default.
• W3152245004 doi "https://doi.org/10.1148/radiol.2021210226" @default.
• W3152245004 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/33788587" @default.
• W3152245004 hasPublicationYear "2021" @default.
• W3152245004 type Work @default.
• W3152245004 sameAs 3152245004 @default.
• W3152245004 citedByCount "1" @default.
• W3152245004 countsByYear W31522450042023 @default.
• W3152245004 crossrefType "journal-article" @default.
• W3152245004 hasAuthorship W3152245004A5059528446 @default.
• W3152245004 hasConcept C121608353 @default.
• W3152245004 hasConcept C126322002 @default.
• W3152245004 hasConcept C2780472235 @default.
• W3152245004 hasConcept C2910710802 @default.
• W3152245004 hasConcept C29456083 @default.
• W3152245004 hasConcept C512399662 @default.
• W3152245004 hasConcept C530470458 @default.
• W3152245004 hasConcept C71924100 @default.
• W3152245004 hasConceptScore W3152245004C121608353 @default.
• W3152245004 hasConceptScore W3152245004C126322002 @default.
• W3152245004 hasConceptScore W3152245004C2780472235 @default.
• W3152245004 hasConceptScore W3152245004C2910710802 @default.
• W3152245004 hasConceptScore W3152245004C29456083 @default.
• W3152245004 hasConceptScore W3152245004C512399662 @default.
• W3152245004 hasConceptScore W3152245004C530470458 @default.
• W3152245004 hasConceptScore W3152245004C71924100 @default.
• W3152245004 hasIssue "3" @default.
• W3152245004 hasLocation W31522450041 @default.
• W3152245004 hasOpenAccess W3152245004 @default.
• W3152245004 hasPrimaryLocation W31522450041 @default.
• W3152245004 hasRelatedWork W1862639475 @default.
• W3152245004 hasRelatedWork W1894294854 @default.
• W3152245004 hasRelatedWork W1968680466 @default.
• W3152245004 hasRelatedWork W2023964005 @default.
• W3152245004 hasRelatedWork W2270092141 @default.
• W3152245004 hasRelatedWork W2403521607 @default.
• W3152245004 hasRelatedWork W4231535373 @default.
• W3152245004 hasRelatedWork W85142379 @default.
• W3152245004 hasRelatedWork W1713349176 @default.
• W3152245004 hasRelatedWork W2182307012 @default.
• W3152245004 hasVolume "299" @default.
• W3152245004 isParatext "false" @default.
• W3152245004 isRetracted "false" @default.
• W3152245004 magId "3152245004" @default.
• W3152245004 workType "article" @default.