Annual mammography at age 45–49 years and biennial mammography at age 50–69 years: comparing performance measures in an organised screening setting

Bucchi, Lauro; Ravaioli, Alessandra; Baldacchini, Flavia; Giuliani, Orietta; Mancini, Silvia; Vattiato, Rosa; Falcini, Fabio; Rossi, Paolo Giorgi; Campari, Cinzia; Canuti, Debora; Felice, Enza Di; Bianchi, Priscilla Sassoli de; Ferretti, Stefano; Bertozzi, Nicoletta

doi:10.1007/s00330-019-06050-w

Cited by 10 publications

(9 citation statements)

References 32 publications

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“… 4 In Italy in 2015/2016, about six million women were invited and about 60% attended; recently in some regions, invitations were extended to 45–49- and 70–74-year-old women. 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy

et al. 2020

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BACKGROUND: Improving the quality of information and communication is a priority in organised breast cancer screening and an ethical duty. Programmes must offer the information each woman is looking for, promoting informed decision-making. This study aimed to develop and evaluate a web-based dynamic decision aid (DA). METHODS: A pragmatic randomised trial carried out in six regional organised screening programmes recruited women at the first invitation receiving DA or a web-based standard brochure (SB). The primary outcome was informed choice measured on knowledge, attitudes, and intentions. Follow-up period: 7-10 days. Secondary outcomes included participation rate, satisfaction, decisional conflict, and acceptability of DA. RESULTS: Two thousand one hundred and nineteen women were randomised and 1001 completed the study. Respectively, 43.9% and 36.9% in the DA and SB reached the informed choice. The DA gave a 13-point higher proportion of women aware about overdiagnosis compared to SB (38.3% versus 25.2%, p < 0.0001). The percentage of women attending screening was the same: 84% versus 83%. Decisional conflict was significantly lower in the DA group (14.4%) than in the SB group (19.3%). CONCLUSION: DA increases informed choice. Complete information including the pros, cons, controversies, and overdiagnosis-overtreatment issues boost a woman's knowledge without reducing the rate of actual screening participation. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov number NCT 03097653.

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“… 4 In Italy in 2015/2016, about six million women were invited and about 60% attended; recently in some regions, invitations were extended to 45–49- and 70–74-year-old women. 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy

et al. 2020

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“…Over-diagnosis and false positive recalls in women younger than 50 years and non-significant lower breast cancer mortality between younger and older breast cancer patients make early breast cancer screening unreliable and unadvisable in the general population. 21 , 22 However, the problem of early detection of breast cancer in women younger than 50 persists and as previously stated, screening of women at higher-than-average risk of breast cancer seems one of the most feasible solutions. Based on data presented, further steps in refining a breast cancer risk calculation tool will have to be done before a tailored screening is implemented, as the inclusion of more breast cancer risk factors like mammographic density.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer risk based on adapted IBIS prediction model in Slovenian women aged 40–49 years - could it be better?

Oblak

Zadnik

Krajc

et al. 2020

Radiology and Oncology

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AbstractBackgroundThe aim of the study was to assess the proportion of women that would be classified as at above-average risk of breast cancer based on the 10 year-risk prediction of the Slovenian breast cancer incidence rate (S-IBIS) program in two presumably above-average breast cancer risk populations in age group 40-49 years: (i) women referred for any reason to diagnostic breast centres and (ii) women who were diagnosed with breast cancer aged 40–49 years. Breast cancer is the commonest female cancer in Slovenia, with an incidence rate below European average. The Tyrer-Cuzick breast cancer risk assessment algorithm was recently adapted to S-IBIS. In Slovenia a tailored mammographic screening for women at above average risk in age group 40–49 years is considered in the future. S-IBIS is a possible tool to select population at above-average risk of breast cancer for tailored screening.Patients and methodsIn 357 healthy women aged 40–49 years referred for any reason to diagnostic breast centres and in 367 female breast cancer patients aged 40–49 years at time of diagnosis 10-years breast cancer risk was calculated using the S-IBIS software. The proportion of women classified as above-average risk of breast cancer was calculated for each subgroup of the study population.Results48.7% of women in the Breast centre group and 39.2% of patients in the breast cancer group had above-average 10-year breast cancer risk. Positive family history of breast cancer was more prevalent in the Breast centre group (p < 0.05).ConclusionsInclusion of additional risk factors into the S-IBIS is warranted in the populations with breast cancer incidence below European average to reliably stratify women into breast cancer risk groups.

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“…5 An overview of performance measures of the screening process among newly invited women has been published. 6 The PI of interval cancer, or the ratio between the number of cancers observed in the inter-screening interval after a negative mammography result and the number of cancers that would be expected in the absence of screening, provides an approximation of one minus mammography sensitivity. The study was designed based on two considerations: (1) the PI in the second interval year increases invariably because mammography sensitivity for cancers in the penultimate year of their preclinical phase is lower; and (2) the ratio between the PI in the second versus the first interval year in the adjacent age group of 50-54 provides an acceptable estimate of the increase that would occur in the second interval year among women aged 45-49 if these were invited to screening biennially.…”

Section: Methodsmentioning

confidence: 99%

“…5 An overview of performance measures of the screening process among newly invited women has been published. 6…”

Section: Methodsmentioning

confidence: 99%

Incidence of interval breast cancer among women aged 45–49 in an organised mammography screening setting

et al. 2020

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Objective To estimate the proportional incidence (PI) of first- and second-year interval breast cancer among women aged 45–49. Methods In the Emilia-Romagna Region (northern Italy), women aged 45–49 are invited to mammography screening annually, and women aged 50–74 biennially. For younger ones, the proportional incidence of interval cancer in the first and unique interval year was calculated using standard methods. For the second, hypothetical year, it was estimated using two different estimates of the ratio between the second- and the first-year proportional incidence observed among women aged 50–54. Overall, 567,151 negative mammography records were used. Results In the first interval year, the observed proportional incidence of interval cancer among women aged 45–49 was 0.27 (95% confidence interval (CI), 0.22–0.33), within the European limit considered desirable for women aged 50–69 (<0.30). In the second, hypothetical interval year, the estimated proportional incidence ranged from 0.61 (95% CI, 0.43–0.86) to 0.48 (95% CI, 0.31–0.76) depending on whether the estimate was based on data from the pre-digital or digital era, respectively. Conclusion The more up-to-date estimate of 0.48, slightly below the maximum limit considered acceptable for women aged 50–69 (<0.50), suggests that a screening interval of two years may also be an acceptable option for women aged 45–49.

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Annual mammography at age 45–49 years and biennial mammography at age 50–69 years: comparing performance measures in an organised screening setting

Cited by 10 publications

References 32 publications

A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy

A dynamic web-based decision aid to improve informed choice in organised breast cancer screening. A pragmatic randomised trial in Italy

Breast cancer risk based on adapted IBIS prediction model in Slovenian women aged 40–49 years - could it be better?

Incidence of interval breast cancer among women aged 45–49 in an organised mammography screening setting

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