Benefits and harms of annual, biennial, or triennial breast cancer mammography screening for women at average risk of breast cancer: a systematic review for the European Commission Initiative on Breast Cancer (ECIBC)
Por:
Canelo-Aybar, C, Posso, M, Montero, N, Sola, I, Saz-Parkinson, Z, Duffy, SW, Follmann, M, Grawingholt, A, Rossi, PG, Alonso-Coello, P
Publicada:
9 mar 2022
Ahead of Print:
1 nov 2021
Resumen:
Background Although mammography screening is recommended in most European countries, the balance between the benefits and harms of different screening intervals is still a matter of debate. This review informed the European Commission Initiative on Breast Cancer (BC) recommendations. Methods We searched PubMed, EMBASE, and the Cochrane Library to identify RCTs, observational or modelling studies, comparing desirable (BC deaths averted, QALYs, BC stage, interval cancer) and undesirable (overdiagnosis, false positive related, radiation related) effects from annual, biennial, or triennial mammography screening in women of average risk for BC. We assessed the certainty of the evidence using the GRADE approach. Results We included one RCT, 13 observational, and 11 modelling studies. In women 50-69, annual compared to biennial screening may have small additional benefits but an important increase in false positive results; triennial compared to biennial screening may have smaller benefits while avoiding some harms. In younger women (aged 45-49), annual compared to biennial screening had a smaller gain in benefits and larger harms, showing a less favourable balance in this age group than in women 50-69. In women 70-74, there were fewer additional harms and similar benefits with shorter screening intervals. The overall certainty of the evidence for each of these comparisons was very low. Conclusions In women of average BC risk, screening intervals have different trade-offs for each age group. The balance probably favours biennial screening in women 50-69. In younger women, annual screening may have a less favourable balance, while in women aged 70-74 years longer screening intervals may be more favourable.
Filiaciones:
Canelo-Aybar, C:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Dept Clin Epidemiol & Publ Hlth, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Autonoma Barcelona, Dept Paediat Obstet & Gynaecol, Prevent Med & Publ Hlth PhD Programme Methodol Bi, Barcelona, Spain
Posso, M:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Dept Clin Epidemiol & Publ Hlth, Barcelona, Spain
IMIM Hosp del Mar Med Res Inst, Dept Epidemiol & Evaluat, Barcelona, Spain
Montero, N:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Dept Clin Epidemiol & Publ Hlth, Barcelona, Spain
Sola, I:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Dept Clin Epidemiol & Publ Hlth, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Saz-Parkinson, Z:
European Commiss, Joint Res Ctr JRC, Ispra, Italy
Duffy, SW:
Queen Mary Univ London, Wolfson Inst Prevent Med, London, England
Follmann, M:
German Canc Soc, Berlin, Germany
Grawingholt, A:
Radiol Theater, Paderborn, Germany
Rossi, PG:
Azienda Unit Sanit Locale IRCCS Reggio Emilia, Epidemiol Unit, Reggio Emilia, Italy
Alonso-Coello, P:
Biomed Res Inst St Pau IIB St Pau, Iberoamer Cochrane Ctr, Dept Clin Epidemiol & Publ Hlth, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
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