Breast Cancer: the decision to screen*

Abstract

LIST OF TABLES IN TEXT 49. Distribution of scores in subgroups before and 3 months after screening 50. Work scheme for screening in Stockholm trial with actual numbers of women involved 51. Comparison of findings in patients referred to the screening clinic (where assessment was) and from hospital outpatient 52. Rates of biopsies (per 1000 women) and benign : malignant ratios reported in screening trials 53. Comparison biopsy rates (per 1000 women) and benign : malignant ratios in USA and Nijmegen over similar periods of screening 54. Predictive value of referral generated by a mammographic biopsy for diagnosis of cancer in Nijmegen programme of screening 55. Relationship age to benign : malignant ratio of biopsies generated by screening in BCDDP 56. Factors influencing risk of developing breast cancer 57. The application of risk factor analyses to selective screening 58. Comparison of costs per quality-adjusted life years gained from various health-care procedures 59. Incidence of contralateral breast cancer in controlled randomised trials of adjuvant therapy for primary breast cancer in which tamoxifen has been given in one arm alone 60. Controlled randomised trials under way in U.K. national breast cancer screening service xxi 153 155

False positive results in a neuroblastoma screening programme

“…children without neuroblastoma) compares very favourably with rates in screening programmes for other conditions; e.g., rates of 3-13% are seen in breast cancer screening programmes using a combination of clinical examination and mammography [7,8]. It also compares favourably with screening procedures in children for nonmalignant conditions, e.g., 6.9% for hypothyroidism [9].…”

Problems of Prioritisation and Our Duty to Care

“…For example, the argument continues about whether or not the breast screening programme should have been implemented [3]. A major contribution to the debate has been an analysis of such statistics as "cost per life saved" (quoted in 1988 at £39,000) [4].…”