Screening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.

<h4>Background</h4>The magnitude of the benefit associated with screening has been debated. We present a meta-analysis of quasi-experimental studies on the effects of mammography screening.<h4>Methods</h4>We searched MEDLINE/PubMed and Embase for articles published through Ja...

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Autores principales:	Veronica L Irvin, Robert M Kaplan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b1d4118f63264688979f39f8e44f039f
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spelling	oai:doaj.org-article:b1d4118f63264688979f39f8e44f039f2021-11-18T08:17:37ZScreening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.1932-620310.1371/journal.pone.0098105https://doaj.org/article/b1d4118f63264688979f39f8e44f039f2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24887150/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The magnitude of the benefit associated with screening has been debated. We present a meta-analysis of quasi-experimental studies on the effects of mammography screening.<h4>Methods</h4>We searched MEDLINE/PubMed and Embase for articles published through January 31, 2013. Studies were included if they reported: 1) a population-wide breast cancer screening program using mammography with 5+ years of data post-implementation; 2) a comparison group with equal access to therapies; and 3) breast cancer mortality. Studies excluded were: RCTs, case-control, or simulation studies. We defined quasi-experimental as studies that compared either geographical, historical or birth cohorts with a screening program to an equivalent cohort without a screening program. Meta-analyses were conducted in Stata using the metan command, random effects. Meta-analyses were conducted separately for ages screened: under 50, 50 to 69 and over 70 and weighted by population and person-years.<h4>Results</h4>Among 4,903 published papers that were retrieved, 19 studies matched eligibility criteria. Birth cohort studies reported a significant benefit for women screened <age 50, but not for women screened ages 50-69. Significant reductions in breast cancer mortality were observed in historical comparisons. For geographical comparisons, there was a significant 20% reduction in mortality for women <age 50 and a significant 21-22% reduction for women ages 50-69. Studies that tested the interaction of geographical and historical comparisons produced a pooled, significant 13-17% reduction in incident breast cancer mortality for women ages 50-69, but the effects in most individual studies were non-significant. All studies of women ages 70+ were non-significant.<h4>Conclusions</h4>Mammography screening may have modest effects on cancer mortality between the ages of 50 and 69 and non-significant effects for women older than age 70. Results are consistent with meta-analyses of RCTs. Effects on total mortality could not be assessed because of the limited number of studies.Veronica L IrvinRobert M KaplanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 6, p e98105 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Veronica L Irvin Robert M Kaplan Screening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.
description	<h4>Background</h4>The magnitude of the benefit associated with screening has been debated. We present a meta-analysis of quasi-experimental studies on the effects of mammography screening.<h4>Methods</h4>We searched MEDLINE/PubMed and Embase for articles published through January 31, 2013. Studies were included if they reported: 1) a population-wide breast cancer screening program using mammography with 5+ years of data post-implementation; 2) a comparison group with equal access to therapies; and 3) breast cancer mortality. Studies excluded were: RCTs, case-control, or simulation studies. We defined quasi-experimental as studies that compared either geographical, historical or birth cohorts with a screening program to an equivalent cohort without a screening program. Meta-analyses were conducted in Stata using the metan command, random effects. Meta-analyses were conducted separately for ages screened: under 50, 50 to 69 and over 70 and weighted by population and person-years.<h4>Results</h4>Among 4,903 published papers that were retrieved, 19 studies matched eligibility criteria. Birth cohort studies reported a significant benefit for women screened <age 50, but not for women screened ages 50-69. Significant reductions in breast cancer mortality were observed in historical comparisons. For geographical comparisons, there was a significant 20% reduction in mortality for women <age 50 and a significant 21-22% reduction for women ages 50-69. Studies that tested the interaction of geographical and historical comparisons produced a pooled, significant 13-17% reduction in incident breast cancer mortality for women ages 50-69, but the effects in most individual studies were non-significant. All studies of women ages 70+ were non-significant.<h4>Conclusions</h4>Mammography screening may have modest effects on cancer mortality between the ages of 50 and 69 and non-significant effects for women older than age 70. Results are consistent with meta-analyses of RCTs. Effects on total mortality could not be assessed because of the limited number of studies.
format	article
author	Veronica L Irvin Robert M Kaplan
author_facet	Veronica L Irvin Robert M Kaplan
author_sort	Veronica L Irvin
title	Screening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.
title_short	Screening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.
title_full	Screening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.
title_fullStr	Screening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.
title_full_unstemmed	Screening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.
title_sort	screening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/b1d4118f63264688979f39f8e44f039f
work_keys_str_mv	AT veronicalirvin screeningmammographybreastcancermortalitymetaanalysisofquasiexperimentalstudies AT robertmkaplan screeningmammographybreastcancermortalitymetaanalysisofquasiexperimentalstudies
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Screening mammography & breast cancer mortality: meta-analysis of quasi-experimental studies.

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