Breast Cancer Screening Controversies

Abstract

Background:The Cochrane Collaborative, a respected independent review body, recently published a meta-analysis of the effectiveness of screening mammography in decreasing breast cancer mortality. Based on the results of two controlled trials they judged to be of medium validity, they concluded that screening mammography was unjustified. In contrast, the US Preventive Services Task Force recently updated their screening recommendations, and based on a meta-analysis of the same randomized controlled trials, they recommended screening mammography for all women starting at age 40 years. Additionally the Canadian Task Force on Preventive Health Care no longer recommends breast selfexamination (BSE). This article reviews the controversies regarding breast cancer screening.Methods: We performed a systematic review of the literature using keywords and cross-referencing articles. We also used automated data from the Breast Cancer Screening Program at Group Health Cooperative to determine the sensitivity of the clinical breast examination (CBE) at our institution. For the latter we included all cancers diagnosed within 1 year of a screening examination and then determined which of those had been found by CBE.

Were Our Estimates of Overdiagnosis With Mammography Screening 
in the United States “Based on Faulty Science”?

“…The one RCT conducted in the U.S. began a half-century ago (1963) and all the others except one began more than 30 years ago (Table 4) [34][35][36][37][38][39][40][41][42][43][44][45][46][47]. The general population studies of overdiagnosis have been conducted since 2000 and reported during the last 7 years (Table 3).…”

The Efficacy of Cognitive Behavioral Therapy for Adults With ADHD: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Meta-analyses may not always be reliable or valid; in some cases meta-analyses using the same studies have found differing results (Green & Taplin, 2003). To address such shortcomings in meta-analyses of RCTs specifically, the QUOROM Statement (Quality of Reporting of Meta-Analyses) was developed (Moher et al, 1999) and updated with the PRISMA statement (Preferred Reporting Items for Systematic reviews and MetaAnalyses) (Moher et al, 2009).…”

Breast Cancer Knowledge and Screening Behaviour among Women with a Positive Family History: A Cross Sectional Study

“…Early detection of breast cancer and presentation at hospitals is crucial for effective treatment and cure, offers good chance for rapid recovery and reduced breast cancer mortality (Sadler et al, 2001;Green and Taplin, 2003;Secginli and Nahcivan, 2006). When detected at the early stage, breast cancer is curable, 93-88% with a 5-year survival rate for Stage 0 and I (American Cancer Society, 2012).…”