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An Overview of the Breast Cancer Screening Controversy

An Overview of the Breast Cancer Screening Controversy Randomized controlled studies show that screening mammograms are as important for women aged 40-49 as for women 50 years old and above. It was the improper use of retrospective, unplanned, sub-group analysis to advise women and their physicians that caused the controversy over mammograms for women under 50. Furthermore, arbitrarily grouping women into two groups leads to the incorrect conclusion that the age of 50 is a significant break point when it is not. The data demonstrates that none of the parameters of screening change abruptly at age 50. The recall rates (an abnormal mammogram) and the rate at which biopsies are recommended are virtually the same, regardless of age. Breast cancer is not a trivial problem for women in their forties. More than 30% of the years of life lost to breast cancer are from women diagnosed while in their forties. Because of changing demographics, in 1995 and 1996, there were actually more women diagnosed with breast cancer in their forties than for women in their fifties. The data clearly show that screening women for breast cancer, on an annual basis, beginning by age 40, can reduce the death rate by approximately 24%. It is important to separate medical and scientific analyses from the economic considerations. “Society” may decide that it is too expensive to screen women for breast cancer, but women should be provided with the scientific and medical information so that they can participate in the discussion of whether screening is “worthwhile” and decide whether or not to avail themselves of its benefit. The economics should not be used to influence the scientific and medical analysis of benefit. Oxford University Press « Previous | Next Article » Table of Contents This Article J Natl Cancer Inst Monogr (1997) 1997 (22): 1-3. This article appears in: National Institutes of Health Consensus Conference on Breast Cancer Screening for Women Ages 40-49 » Abstract Free Full Text (HTML) Free Full Text (PDF) Free Classifications Article Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Kopans, D. B. Search for related content PubMed PubMed citation Articles by Kopans, D. B. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue May 2015 2015 (51) Alert me to new issues The Journal About this journal Rights & Permissions We are mobile – find out more Journals Career Network Editor-in-Chief Carmen J. Allegra View the JNCI editorial board For Authors Instructions to authors Author Self Archiving Policy Alerting Services Email table of contents CiteTrack XML RSS feed Corporate Services Advertising sales Reprints var taxonomies = ("MED00300"); Most Most Read Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer Descriptive Review of the Literature on Breast Cancer Outcomes: 1990 Through 2000 Prevalence of Depression in Patients With Cancer Biology of Oral Mucosa and Esophagus Chapter 6: Estrogen Metabolism by Conjugation » View all Most Read articles Most Cited Chapter 1: Human Papillomavirus and Cervical Cancer--Burden and Assessment of Causality Chapter 4: Estrogens as Endogenous Genotoxic Agents--DNA Adducts and Mutations Prevalence of Depression in Patients With Cancer Preoperative Chemotherapy in Patients With Operable Breast Cancer: Nine-Year Results From National Surgical Adjuvant Breast and Bowel Project B-18 Overview of the Randomized Trials of Radiotherapy in Ductal Carcinoma In Situ of the Breast » View all Most Cited articles Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department. Online ISSN 1745-6614 - Print ISSN 1052-6773 Copyright © 2015 Oxford University Press Oxford Journals Oxford University Press Site Map Privacy Policy Cookie Policy Legal Notices Frequently Asked Questions Other Oxford University Press sites: Oxford University Press Oxford Journals China Oxford Journals Japan Academic & Professional books Children's & Schools Books Dictionaries & Reference Dictionary of National Biography Digital Reference English Language Teaching Higher Education Textbooks International Education Unit Law Medicine Music Online Products & Publishing Oxford Bibliographies Online Oxford Dictionaries Online Oxford English Dictionary Oxford Language Dictionaries Online Oxford Scholarship Online Reference Rights and Permissions Resources for Retailers & Wholesalers Resources for the Healthcare Industry Very Short Introductions World's Classics function fnc_onDomLoaded() { var query_context = getQueryContext(); PF_initOIUnderbar(query_context,":QS:default","","JRN"); PF_insertOIUnderbar(0); }; if (window.addEventListener) { window.addEventListener('load', fnc_onDomLoaded, false); } else if (window.attachEvent) { window.attachEvent('onload', fnc_onDomLoaded); } var gaJsHost = (("https:" == document.location.protocol) ? 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An Overview of the Breast Cancer Screening Controversy

JNCI Monographs , Volume 1997 (22) – Jan 1, 1997

An Overview of the Breast Cancer Screening Controversy

JNCI Monographs , Volume 1997 (22) – Jan 1, 1997

Abstract

Randomized controlled studies show that screening mammograms are as important for women aged 40-49 as for women 50 years old and above. It was the improper use of retrospective, unplanned, sub-group analysis to advise women and their physicians that caused the controversy over mammograms for women under 50. Furthermore, arbitrarily grouping women into two groups leads to the incorrect conclusion that the age of 50 is a significant break point when it is not. The data demonstrates that none of the parameters of screening change abruptly at age 50. The recall rates (an abnormal mammogram) and the rate at which biopsies are recommended are virtually the same, regardless of age. Breast cancer is not a trivial problem for women in their forties. More than 30% of the years of life lost to breast cancer are from women diagnosed while in their forties. Because of changing demographics, in 1995 and 1996, there were actually more women diagnosed with breast cancer in their forties than for women in their fifties. The data clearly show that screening women for breast cancer, on an annual basis, beginning by age 40, can reduce the death rate by approximately 24%. It is important to separate medical and scientific analyses from the economic considerations. “Society” may decide that it is too expensive to screen women for breast cancer, but women should be provided with the scientific and medical information so that they can participate in the discussion of whether screening is “worthwhile” and decide whether or not to avail themselves of its benefit. The economics should not be used to influence the scientific and medical analysis of benefit. Oxford University Press « Previous | Next Article » Table of Contents This Article J Natl Cancer Inst Monogr (1997) 1997 (22): 1-3. This article appears in: National Institutes of Health Consensus Conference on Breast Cancer Screening for Women Ages 40-49 » Abstract Free Full Text (HTML) Free Full Text (PDF) Free Classifications Article Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Kopans, D. B. Search for related content PubMed PubMed citation Articles by Kopans, D. B. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue May 2015 2015 (51) Alert me to new issues The Journal About this journal Rights & Permissions We are mobile – find out more Journals Career Network Editor-in-Chief Carmen J. Allegra View the JNCI editorial board For Authors Instructions to authors Author Self Archiving Policy Alerting Services Email table of contents CiteTrack XML RSS feed Corporate Services Advertising sales Reprints var taxonomies = ("MED00300"); Most Most Read Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer Descriptive Review of the Literature on Breast Cancer Outcomes: 1990 Through 2000 Prevalence of Depression in Patients With Cancer Biology of Oral Mucosa and Esophagus Chapter 6: Estrogen Metabolism by Conjugation » View all Most Read articles Most Cited Chapter 1: Human Papillomavirus and Cervical Cancer--Burden and Assessment of Causality Chapter 4: Estrogens as Endogenous Genotoxic Agents--DNA Adducts and Mutations Prevalence of Depression in Patients With Cancer Preoperative Chemotherapy in Patients With Operable Breast Cancer: Nine-Year Results From National Surgical Adjuvant Breast and Bowel Project B-18 Overview of the Randomized Trials of Radiotherapy in Ductal Carcinoma In Situ of the Breast » View all Most Cited articles Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department. Online ISSN 1745-6614 - Print ISSN 1052-6773 Copyright © 2015 Oxford University Press Oxford Journals Oxford University Press Site Map Privacy Policy Cookie Policy Legal Notices Frequently Asked Questions Other Oxford University Press sites: Oxford University Press Oxford Journals China Oxford Journals Japan Academic & Professional books Children's & Schools Books Dictionaries & Reference Dictionary of National Biography Digital Reference English Language Teaching Higher Education Textbooks International Education Unit Law Medicine Music Online Products & Publishing Oxford Bibliographies Online Oxford Dictionaries Online Oxford English Dictionary Oxford Language Dictionaries Online Oxford Scholarship Online Reference Rights and Permissions Resources for Retailers & Wholesalers Resources for the Healthcare Industry Very Short Introductions World's Classics function fnc_onDomLoaded() { var query_context = getQueryContext(); PF_initOIUnderbar(query_context,":QS:default","","JRN"); PF_insertOIUnderbar(0); }; if (window.addEventListener) { window.addEventListener('load', fnc_onDomLoaded, false); } else if (window.attachEvent) { window.attachEvent('onload', fnc_onDomLoaded); } var gaJsHost = (("https:" == document.location.protocol) ? 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Publisher
Oxford University Press
Copyright
Copyright © 2015 Oxford University Press
ISSN
1052-6773
eISSN
1745-6614
DOI
jncimono;1997/22/1
Publisher site
See Article on Publisher Site

Abstract

Randomized controlled studies show that screening mammograms are as important for women aged 40-49 as for women 50 years old and above. It was the improper use of retrospective, unplanned, sub-group analysis to advise women and their physicians that caused the controversy over mammograms for women under 50. Furthermore, arbitrarily grouping women into two groups leads to the incorrect conclusion that the age of 50 is a significant break point when it is not. The data demonstrates that none of the parameters of screening change abruptly at age 50. The recall rates (an abnormal mammogram) and the rate at which biopsies are recommended are virtually the same, regardless of age. Breast cancer is not a trivial problem for women in their forties. More than 30% of the years of life lost to breast cancer are from women diagnosed while in their forties. Because of changing demographics, in 1995 and 1996, there were actually more women diagnosed with breast cancer in their forties than for women in their fifties. The data clearly show that screening women for breast cancer, on an annual basis, beginning by age 40, can reduce the death rate by approximately 24%. It is important to separate medical and scientific analyses from the economic considerations. “Society” may decide that it is too expensive to screen women for breast cancer, but women should be provided with the scientific and medical information so that they can participate in the discussion of whether screening is “worthwhile” and decide whether or not to avail themselves of its benefit. The economics should not be used to influence the scientific and medical analysis of benefit. Oxford University Press « Previous | Next Article » Table of Contents This Article J Natl Cancer Inst Monogr (1997) 1997 (22): 1-3. This article appears in: National Institutes of Health Consensus Conference on Breast Cancer Screening for Women Ages 40-49 » Abstract Free Full Text (HTML) Free Full Text (PDF) Free Classifications Article Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Kopans, D. B. Search for related content PubMed PubMed citation Articles by Kopans, D. B. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue May 2015 2015 (51) Alert me to new issues The Journal About this journal Rights & Permissions We are mobile – find out more Journals Career Network Editor-in-Chief Carmen J. Allegra View the JNCI editorial board For Authors Instructions to authors Author Self Archiving Policy Alerting Services Email table of contents CiteTrack XML RSS feed Corporate Services Advertising sales Reprints var taxonomies = ("MED00300"); Most Most Read Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer Descriptive Review of the Literature on Breast Cancer Outcomes: 1990 Through 2000 Prevalence of Depression in Patients With Cancer Biology of Oral Mucosa and Esophagus Chapter 6: Estrogen Metabolism by Conjugation » View all Most Read articles Most Cited Chapter 1: Human Papillomavirus and Cervical Cancer--Burden and Assessment of Causality Chapter 4: Estrogens as Endogenous Genotoxic Agents--DNA Adducts and Mutations Prevalence of Depression in Patients With Cancer Preoperative Chemotherapy in Patients With Operable Breast Cancer: Nine-Year Results From National Surgical Adjuvant Breast and Bowel Project B-18 Overview of the Randomized Trials of Radiotherapy in Ductal Carcinoma In Situ of the Breast » View all Most Cited articles Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department. Online ISSN 1745-6614 - Print ISSN 1052-6773 Copyright © 2015 Oxford University Press Oxford Journals Oxford University Press Site Map Privacy Policy Cookie Policy Legal Notices Frequently Asked Questions Other Oxford University Press sites: Oxford University Press Oxford Journals China Oxford Journals Japan Academic & Professional books Children's & Schools Books Dictionaries & Reference Dictionary of National Biography Digital Reference English Language Teaching Higher Education Textbooks International Education Unit Law Medicine Music Online Products & Publishing Oxford Bibliographies Online Oxford Dictionaries Online Oxford English Dictionary Oxford Language Dictionaries Online Oxford Scholarship Online Reference Rights and Permissions Resources for Retailers & Wholesalers Resources for the Healthcare Industry Very Short Introductions World's Classics function fnc_onDomLoaded() { var query_context = getQueryContext(); PF_initOIUnderbar(query_context,":QS:default","","JRN"); PF_insertOIUnderbar(0); }; if (window.addEventListener) { window.addEventListener('load', fnc_onDomLoaded, false); } else if (window.attachEvent) { window.attachEvent('onload', fnc_onDomLoaded); } var gaJsHost = (("https:" == document.location.protocol) ? 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Journal

JNCI MonographsOxford University Press

Published: Jan 1, 1997

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