programas cribado cancer


Nota Bibliográfica

Esta Nota es una recopilación de publicaciones (artículos, informes, libros) sobre cribado de cáncer resultado de una revisión no sistemática de la literatura.

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Josep A Espinás. Pla Director d'Oncología de Catalunya.
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Nota bibliográfica cribado de c mama 2012-10

The Lancet. The breast cancer screening debate: closing a chapter? editorial. Lancet 2012 Oct 30;(0).  DOI: doi: 10.1016/S0140-6736(12)61775-9
Independent UK Panel on Breast Cancer Screening. The benefits and harms of breast cancer screening: an independent review. Lancet 2012 Oct 30.  DOI: 10.1016/S0140-6736(12)61611-0
The Panel concludes that screening reduces breast cancer mortality but that some overdiagnosis occurs. Since the estimates provided are from studies with many limitations and whose relevance to present-day screening programmes can be questioned, they have substantial uncertainty and should be regarded only as an approximate guide. If these figures are used directly, for every 10?000 UK women aged 50 years invited to screening for the next 20 years, 43 deaths from breast cancer would be prevented and 129 cases of breast cancer, invasive and non-invasive, would be overdiagnosed; that is one breast cancer death prevented for about every three overdiagnosed cases identified and treated. Of the roughly 307?000 women aged 50?52 years who are invited to begin screening every year, just over 1% would have an overdiagnosed cancer in the next 20 years. Evidence from a focus group organised by Cancer Research UK and attended by some members of the Panel showed that many women feel that accepting the offer of breast screening is worthwhile, which agrees with the results of previous similar studies. Information should be made available in a transparent and objective way to women invited to screening so that they can make informed decisions
Michell MJ, Iqbal A, Wasan RK, Evans DR, Peacock C, Lawinski CP, et al. A comparison of the accuracy of film-screen mammography, full-field digital mammography, and digital breast tomosynthesis. Clin Radiol 2012 Oct;67(10):976-81.  DOI: S0009-9260(12)00145-6 [pii];10.1016/j.crad.2012.03.009 [doi]  PM:22625656
CONCLUSION: The addition of DBT increases the accuracy of mammography compared to FFDM and film-screen mammography combined and film-screen mammography alone in the assessment of screen-detected soft-tissue mammographic abnormalities
Sala M, Salas D, Zubizarreta R, Ascunce N, Rue M, Castells X, et al. Situación de la investigación en el cribado de cáncer de mama en España: implicaciones para la prevención. Gac Sanit 2012 Mar 15;26(6):574-81.  DOI: S0213-9111(12)00060-X [pii];10.1016/j.gaceta.2011.11.013 [doi]  PM:22424970
CONCLUSIONS: The results obtained will be included in mathematical models currently under development to evaluate the efficiency of breast cancer screening. These models could be highly useful to provide information and guide clinical and health policy decisions on cancer prevention and control


Nota bibliográfica cribado de c mama 2012-09

Hackshaw A. The benefits and harms of mammographic screening for breast cancer: building the evidence base using service screening programmes editorial. J Med Screen 2012 Sep 1;19(suppl 1):1-2.  DOI: 10.1258/jms.2012.012074
Zappa M, Federici A. Introduction Comentary. J Med Screen 2012 Sep 1;19(suppl 1):3-4.  DOI: 10.1258/jms.2012.012075
Paci E. Summary of the evidence of breast cancer service screening outcomes in Europe and first estimate of the benefit and harm balance sheet. J Med Screen 2012 Sep 1;19(suppl 1):5-13.  DOI: 10.1258/jms.2012.012077
Conclusions The chance of saving a woman's life by population-based mammographic screening of appropriate quality is greater than that of over-diagnosis. Service screening in Europe achieves a mortality benefit at least as great as the randomized controlled trials. These outcomes should be communicated to women offered service screening in Europe
Broeders M, Moss S, Nystr+Âm L, Njor S, Jonsson H+, Paap E, et al. The impact of mammographic screening on breast cancer mortality in Europe: a review of observational studies. J Med Screen 2012 Sep 1;19(suppl 1):14-25.  DOI: 10.1258/jms.2012.012078
Conclusions Valid observational designs are those where sufficient longitudinal individual data are available, directly linking a woman's screening history to her cause of death. From such studies, the best European estimate of breast cancer mortality reduction is 25 -31% for women invited for screening, and 38-48% for women actually screened. Much of the current controversy on breast cancer screening is due to the use of inappropriate methodological approaches that are unable to capture the true effect of mammographic screening
Moss SM, Nystrøm L, Jonsson H, Paci E, Lynge E, Njor S, et al. The impact of mammographic screening on breast cancer mortality in Europe: a review of trend studies. J Med Screen 2012 Sep 1;19(suppl 1):26-32.  DOI: 10.1258/jms.2012.012079
Conclusions Although analysing population breast cancer mortality rates over time can be a first step in examining changes following the introduction of screening, this method is of limited value for assessment of screening impact. Other methods and individual data are necessary to properly quantify the effect
Njor S, Nystrøm L, Moss S, Paci E, Broeders M, Segnan N, et al. Breast cancer mortality in mammographic screening in Europe: a review of incidence-based mortality studies. J Med Screen 2012 Sep 1;19(suppl 1):33-41.  DOI: 10.1258/jms.2012.012080
Conclusions Based on evidence from the most methodologically sound IBM studies, the most likely impact of European service mammography screening programmes was a breast cancer mortality reduction of 26% (95% confidence interval 13-36%) among women invited for screening and followed up for 6-11 years
Puliti D, Duffy SW, Miccinesi G, de Koning H, Lynge E, Zappa M, et al. Overdiagnosis in mammographic screening for breast cancer in Europe: a literature review. J Med Screen 2012 Sep 1;19(suppl 1):42-56.  DOI: 10.1258/jms.2012.012082
Conclusions The most plausible estimates of overdiagnosis range from 1% to 10%. Substantially higher estimates of overdiagnosis reported in the literature are due to the lack of adjustment for breast cancer risk and/or lead time
Hofvind S, Ponti A, Patnick J, Ascunce N, Njor S, Broeders M, et al. False-positive results in mammographic screening for breast cancer in Europe: a literature review and survey of service screening programmes. J Med Screen 2012 Sep 1;19(suppl 1):57-66.  DOI: 10.1258/jms.2012.012083
Conclusion The specific investigative procedures following a recall should be considered when examining the cumulative risk of a false-positive screening result. Most women with a positive screening test undergo a non-invasive assessment procedure. Only a small proportion of recalled women undergo needle biopsy, and even fewer undergo surgical intervention
Giordano L, Cogo C, Patnick J, Paci E. Communicating the balance sheet in breast cancer screening. J Med Screen 2012 Sep 1;19(suppl 1):67-71.  DOI: 10.1258/jms.2012.012084
Conclusion The balance sheet could be a starting point for a broader vision of informed decision-making in screening, which should also recognize the role played by non-numerical  factors on women's choice of participating in breast cancer screening
Giordano L, von Karsa L, Tomatis M, Majek O, de Wolf C, Lancucki L, et al. Mammographic screening programmes in Europe: organization, coverage and participation. J Med Screen 2012 Sep 1;19(suppl 1):72-82.  DOI: 10.1258/jms.2012.012085
Conclusions The results demonstrate the feasibility of European-wide screening monitoring using the EBCSM data warehouse, although further efforts to refine the system and to harmonize standards and data collection practices will be required, to fully integrate all European countries. The more than three-fold difference in the examination coverage should be taken into account in the evaluation of service screening programmes
Nickson C, Mason KE, English DR, Kavanagh AM. Mammographic Screening and Breast Cancer Mortality: A CaseGÇôControl Study and Meta-analysis. Cancer Epidemiology Biomarkers & Prevention 2012 Sep 1;21(9):1479-88.  DOI: 10.1158/1055-9965.EPI-12-0468
Conclusions: Our findings suggest an average 49% reduction in breast cancer mortality for women who are screened. In practice, theoretical biases have little effect on estimates from case-control studies.Impact: Case-control studies, such as ours, provide robust and consistent evidence that screening benefits women who choose to be screened.
Oh KM, Zhou QP, Kreps GL, Ryu SK. Breast cancer screening practices among Asian Americans and Pacific Islanders. Am J Health Behav 2012 Sep;36(5):711-22.  DOI: 10.5993/AJHB.36.5.13 [doi]  PM:22584098
CONCLUSION: Understanding the magnitude and predictors of these disparities for racial/ethnic groups can help inform targeted interventions
Redondo A, Comas M, Macia F, Ferrer F, Murta-Nascimento C, Maristany MT, et al. Inter- and intraradiologist variability in the BI-RADS assessment and breast density categories for screening mammograms. Br J Radiol 2012 Sep 19.  DOI: 21256379 [pii];10.1259/bjr/21256379 [doi]  PM:22993385
Conclusion: We observed a substantial intra-observer agreement in the BI-RADS assessment but only moderate interobserver agreement. Both inter- and intra-observer agreement in mammographic interpretation of breast density was substantial.Advances in knowledge: Educational efforts should be made to decrease radiologists' variability in BI-RADS assessment interpretation in population-based breast screening programmes
Timmers JM, van Doorne-Nagtegaal HJ, Verbeek AL, Den Heeten GJ, Broeders MJ. A dedicated BI-RADS training programme: effect on the inter-observer variation among screening radiologists. Eur J Radiol 2012 Sep;81(9):2184-8.  DOI: S0720-048X(11)00650-4 [pii];10.1016/j.ejrad.2011.07.011 [doi]  PM:21899969
CONCLUSION: Our training programme in the BI-RADS lexicon resulted in a significant improvement of agreement among new screening radiologists. Overall, the agreement among radiologists was moderate (guidelines Landis and Koch). This is in line with results found in the literature
Timmers JM, van Doorne-Nagtegaal HJ, Zonderland HM, van TH, Visser O, Verbeek AL, et al. The Breast Imaging Reporting and Data System (BI-RADS) in the Dutch breast cancer screening programme: its role as an assessment and stratification tool. Eur Radiol 2012 Aug;22(8):1717-23.  PMC3387359  DOI: 10.1007/s00330-012-2409-2 [doi]  PM:22415412
CONCLUSION: The significant differences in PPV, invasive procedures and tumour size match with stratification into BI-RADS categories. It revealed inter-observer variability between screening radiologists and can thus be used as a quality assessment tool in screening and as a stratification tool in diagnostic work-up. KEY POINTS: * The BI-RADS atlas is widely used in breast cancer screening programmes. * There were significant differences in results amongst different BI-RADS categories. * Those differences represented the radiologists' degree of suspicion for malignancy, thus enabling stratification of referrals. * BI-RADS can be used as a quality assessment tool in screening. * Training should create more uniformity in applying the BI-RADS lexicon
van Agt H, Fracheboud J, van der Steen A, de Koning H. Do women make an informed choice about participating in breast cancer screening? A survey among women invited for a first mammography screening examination. Patient Education and Counseling 2012;(0).  DOI: doi: 10.1016/j.pec.2012.08.003
Conclusions Women were deemed to have sufficient relevant knowledge of the benefits and harms if they answered at least half of the items correctly. Practice implications To further increase informed choices in breast cancer screening, information on some of the possible harms merits further attention
van Breest Smallenburg V, Duijm LEM, Voogd AC, Jansen FH, Louwman MWJ. Mammographic changes resulting from benign breast surgery impair breast cancer detection at screening mammography. Eur J Cancer 2012 Sep;48(14):2097-103.  DOI: doi: 10.1016/j.ejca.2012.03.011
Conclusion Previous benign breast surgery decreases screening sensitivity and this is likely due to postoperative mammographic changes


Nota bibliográfica cribado de c mama 2012-08

Hofvind S, Lee C, Elmore J. Stage-specific breast cancer incidence rates among participants and non-participants of a population-based mammographic screening program. Breast Cancer Res Treat 2012 Aug 1;135(1):291-9.
Conclusion: Compared with women invited who did not participate, participants in the screening program are more likely to be diagnosed with DCIS and early stage invasive breast cancer and are less likely to be diagnosed with advanced stage breast cancer. More research is required to determine whether these differences in stage-specific incidences among invited participants and non-participants are associated with differences in mortality rates
Solbjør M, Skolbekken JA, S+ªtnan AR, Hagen AI, Forsmo S. Mammography screening and trust: The case of interval breast cancer. Social Science & Medicine 2012 Aug;(0).   DOI:10.1016/j.socscimed.2012.07.029
Interval cancer is cancer detected between screening rounds among screening participants. In the Norwegian Breast Cancer Screening Programme, 19 per 10,000 screened women are diagnosed with interval cancer. We conducted semi-structured interviews with 26 such women. The women interpreted their interval breast cancer in two ways: that mammography can never be completely certain, or as an experience characterized by shock and doubts about the technology and the conduct of the medical experts. Being diagnosed with interval cancer thus influenced their trust in mammography, but not necessarily to the point of creating distrust. The women saw themselves as exceptions in an otherwise beneficial screening programme. Convinced that statistics had shown benefits from mammography screening and knowing others whose malignant tumours had been detected in the programme, the women bracketed their own experiences and continued trusting mammography screening. Facing a potentially lethal disease and a lack of alternatives to mammography screening left the women with few options but to trust the programme in order to maintain hope. In other words, trust may not only be a basis for hope, but also a consequence of it


Nota bibliográfica cribado c mama 2012-07

Autier P, Koechlin A, Smans M, Vatten L, Boniol M. Mammography Screening and Breast Cancer Mortality in Sweden. J Natl Cancer Inst 2012 Jul 17.  DOI: 10.1093/jnci/djs272

Conclusion County-specific mortality statistics in Sweden are consistent with studies that have reported limited or no impact of screening on mortality from breast cancer

** Segnan N, Rosso S, Ponti A. Is the Breast Cancer Mortality Decrease in Sweden Due to Screening or Treatment? Not the Right Question. J Natl Cancer Inst 2012 Jul 17.  DOI: 10.1093/jnci/djs290
Vannier MW. Screening Mammography: What Good Is It and How Can We Know If It Works? editorial. J Natl Cancer Inst 2012 Jul 17.  DOI: 10.1093/jnci/djs289
Gøtzsche PC. Mammography screening: truth, lies, and controversy carta. Lancet 2012 Jul 21;380(9838):218.  DOI: doi: 10.1016/S0140-6736(12)61216-1
Jorgensen K. Is the tide turning against breast screening? editorial. Breast Cancer Research 2012;14(4):107.  DOI: 10.1186/bcr3212
Herein I argue that mammographic screening has not delivered on its fundamental premise: to reduce the incidence of advanced breast cancer. Indeed, achieving this goal is required if screening is to reduce breast cancer mortality or mastectomy use. Rather, screening has caused substantial increases in the incidence of in situ and early invasive cancers. Moreover, evidence indicates that these screen-detected cancers are unlikely to be cases that were 'caught early', but instead represent women who would not have been diagnosed in the absence of screening and who, as a result, have received harmful, unnecessary treatment. If true, these observations raise the specter that screening creates breast cancer patients and that this practice carries little or no benefit
Maurice A, Evans DG, Affen J, Greenhalgh R, Duffy SW, Howell A. Surveillance of women at increased risk of breast cancer using mammography and clinical breast examination: further evidence of benefit. Int J Cancer 2012 Jul 15;131(2):417-25.  DOI: 10.1002/ijc.26394 [doi]  PM:21898384
We conclude that screening by annual mammography and CBE between age 35-50 years and 18 monthly from 50 to 60 years may diagnose breast cancer in a less advanced state in terms of size and node status compared with symptomatic cancers and, apart from BRCA1 carriers, is likely to contribute to improved long-term outcome compared with no surveillance
Nederend J, Duijm L, Voogd A, Groenewoud J, Jansen F, Louwman M. Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study. Breast Cancer Research 2012;14(1):R10.  DOI: 10.1186/bcr3091
CONCLUSION: We observed no decline in the risk of advanced breast cancer during 12 years of biennial screening mammography. The majority of these cancers could not have been prevented through earlier detection at screening


Nota bibliográfica cribado c mama 2012-06

Allan H. Benefits and harms of mammography screening editorial. BMJ 2012 Jan 6;344.  DOI: 10.1136/bmj.d8279
Ascunce N, Delfrade J, Salas D, Zubizarreta R, Ederra M, en nombre de Red de Program. Programas de detección precoz de cáncer de mama en España: características y principales resultados. Med Clin (Barc ) 2012 Jun 13.  DOI: S0025-7753(12)00414-9 [pii];10.1016/j.medcli.2012.03.030 [doi]
CONCLUSIONS: Despite the variability evident in the data provided by the different autonomous communities and the need to improve the homogeneity of information systems as a whole, the assessed indicators meet the standards specified in the European guidelines

Hofvind S, Sakshaug S, Ursin G, Graff-Iversen S. Breast cancer incidence trends in Norway--explained by hormone therapy or mammographic screening? Int J Cancer 2012 Jun 15;130(12):2930-8.  DOI: 10.1002/ijc.26280 [doi]
In conclusion, the interpretation of breast cancer incidence trends in Norway from 1987 to 2009 is complicated because the NBCSP was introduced during a period with increasing HT use. Both factors likely contributed to the observed trends, and the role of each may vary across age groups

Javitt MC, Hendrick RE, Keen JD, Jorgensen KJ, Orton CG. Recent data show that mammographic screening of asymptomatic women is effective and essential. Medical Physics 2012 Jul;39(7):4047-50.
Raftery J, Chorozoglou M. Possible net harms of breast cancer screening: updated modelling of Forrest report. BMJ 2011 Dec 8;343.  DOI: 10.1136/bmj.d7627
Conclusions This analysis supports the claim that the introduction of breast cancer screening might have caused net harm for up to 10 years after the start of screening.

Seigneurin A, François O, Labarère J, udeville P, Monlong J, Colonna M. Overdiagnosis from non-progressive cancer detected by screening mammography: stochastic simulation study with calibration to population based registry data. BMJ 2011 Nov 23;343.  DOI: 10.1136/bmj.d7017
Conclusion Overdiagnosis from the detection of non-progressive disease by screening mammography was limited in 1991-2006 in Is+¿re. Because carcinoma in situ accounted for less than 15% of all incident breast cancer cases, its contribution to overdiagnosis was relatively limited and imprecise.

Sim MJH, Siva SP, Ramli IS, Fritschi L, Tresham J, Wylie EJ. Effect of false-positive screening mammograms on rescreening in Western Australia. Med J Aust 2012;196(11):693-5.


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