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Screening for breast cancer in England: past and future

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TLDR
Although some have questioned the value of screening for breast cancer, the scientific evidence demonstrates clearly that regular mammographic screening between the ages of 50 and 70 years reduces mortality from the malignancy.
Abstract
• The NHS Breast Screening Programme (NHSBSP) began in 1988. It aims to invite all women aged 50–70 years for mammographic screening once every three years. The programme now screens 1.3 million women each year, about 75% of those invited, and diagnoses about 10,000 breast cancers annually. • Although some have questioned the value of screening for breast cancer, the scientific evidence demonstrates clearly that regular mammographic screening between the ages of 50 and 70 years reduces mortality from the malignancy. • Screened women are slightly more likely than unscreened women to be diagnosed with breast cancer. The cancers in screened women are smaller and are less likely to be treated with mastectomy than they would have been if diagnosed without screening. •For every 400 women screened regularly by the NHSBSP over a 10-year period, one woman fewer will die from breast cancer than would have died without screening. • The current NHSBSP saves an estimated 1400 lives each year in England. • The screening programme spends about £3000 for every year of life saved.

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Citations
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Journal ArticleDOI

The benefits and harms of breast cancer screening: an independent review

TL;DR: It is concluded that screening reduces breast cancer mortality but that some overdiagnosis occurs, and results from observational studies support the occurrence of over Diagnosis, but estimates of its magnitude are unreliable.
Journal ArticleDOI

The benefits and harms of breast cancer screening: an independent review

TL;DR: The authors of as discussed by the authors reviewed the evidence on benefits and harms of breast screening in the context of the UK breast cancer screening programs and concluded that a 20% reduction is still the most reasonable estimate of the effect of the current UK screening programmes on breast cancer mortality.
Journal ArticleDOI

Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends

TL;DR: One in three breast cancers detected in a population offered organised screening is overdiagnosed, with data from three countries showing a drop in incidence as the women exceeded the age limit for screening, but the reduction was small.
Journal Article

Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years' follow-up: a randomised controlled trial. Commentary

TL;DR: Although the reduction in breast-cancer mortality observed in this trial is not significant, it is consistent with results of other trials of mammography alone in this age-group and should take account of possible costs and harms as well as benefits.
Journal ArticleDOI

Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years' follow-up: a randomised controlled trial

TL;DR: In this paper, the intention-to-treat principle was used to compare mortality rates in the two groups at 10 years' follow-up and the results showed a reduction in breast cancer mortality in the intervention group in relative and absolute terms.
References
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Journal ArticleDOI

Breast cancer and hormone-replacement therapy in the Million Women Study.

Valerie Beral
- 09 Aug 2003 - 
TL;DR: Current use of HRT is associated with an increased risk of incident and fatal breast cancer; the effect is substantially greater for oestrogen-progestagen combinations than for other types of H RT.
Journal ArticleDOI

Screening for breast cancer with mammography.

TL;DR: It is found that breast cancer mortality was an unreliable outcome that was biased in favour of screening, mainly because of differential misclassification of cause of death.
Journal ArticleDOI

Comparison of the Performance of Screening Mammography, Physical Examination, and Breast US and Evaluation of Factors that Influence Them: An Analysis of 27,825 Patient Evaluations

TL;DR: Mammographic sensitivity for breast cancer declines significantly with increasing breast density and is independently higher in older women with dense breasts, which significantly increases detection of small cancers and depicts significantly more cancers and at smaller size and lower stage than does PE, which detects independently extremely few cancers.
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