Impact of use of hormone replacement therapy on false positive recall in the NHS breast screening programme: results from the million women study

Banks, Emily; Reeves, Gillian; Beral, Valerie; Bull, Diana; Crossley, Barbara; Simmonds, Moya; Hilton, Elizabeth; Bailey, Stephen P.; Barrett, Nigel; Briers, Peter; English, Ruth; Jackson, A.; Kutt, Elizabeth; Lavelle, Janet; Rockall, Linda; Wallis, Matthew; Wilson, Mary; Patnick, Julietta

doi:10.1136/bmj.328.7451.1291

Cited by 28 publications

(20 citation statements)

References 4 publications

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“…Reliable data on how these measures vary between women are lacking. We examined how women's personal characteristics influence the sensitivity and specificity of mammography in a large cohort of women attending the UK NHS breast screening programme 1 2…”

Section: Introductionmentioning

confidence: 99%

Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study

Banks

Reeves

Beral

et al. 2004

BMJ

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102

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Objectives To examine how lifestyle, hormonal, and other factors influence the sensitivity and specificity of mammography. Methods Women recruited into the Million Women Study completed a questionnaire about various personal factors before routine mammographic screening. A sample of 122 355 women aged 50-64 years were followed for outcome of screening and incident breast cancer in the next 12 months. Sensitivity and specificity were calculated by using standard definitions, with adjustment for potential confounding factors. Results Breast cancer was diagnosed in 726 (0.6%) women, 629 in screen positive and 97 in screen negative women; 3885 (3.2%) were screen positive but had no subsequent diagnosis of breast cancer. Overall sensitivity was 86.6% and specificity was 96.8%. Three factors had an adverse effect on both measures: use of hormone replacement therapy (sensitivity: 83.0% (95% confidence interval 77.4% to 87.6%), 84.7% (73.9% to 91.6%), and 92.1% (87.6% to 95.0%); specificity: 96.8% (96.6% to 97.0%), 97.8% (97.5% to 98.0%), and 98.1% (98.0% to 98.2%), respectively, for current, past, and never use); previous breast surgery v no previous breast surgery (sensitivity: 83.5% (75.7% to 89.1%) v 89.4% (86.5% to 91.8%); specificity: 96.2% (95.8% to 96.5%) v 97.4% (97.3% to 97.5%), respectively); and body mass index < 25 v ≥ 25 (sensitivity: 85.7% (81.2% to 89.3%) v 91.0% (87.5% to 93.6%); specificity: 97.2% (97.0% to 97.3%) v 97.4% (97.3% to 97.6%), respectively). Neither sensitivity nor specificity varied significantly according to age, family history of breast cancer, parity, past oral contraceptive use, tubal ligation, physical activity, smoking, or alcohol consumption. Conclusions The efficiency, and possibly the effectiveness, of mammographic screening is lower in users of hormone replacement therapy, in women with previous breast surgery, and in thin women compared with other women.

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Section: Introductionmentioning

confidence: 99%

Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study

Banks

Reeves

Beral

et al. 2004

BMJ

Self Cite

102

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“…In the developed world, HRT came in to disrepute because of Women's Health Initiative and Million Women Study, the prescription dropped down, but later as more evidences emerged it has got its place in treatment of symptom of menopause and prevention of osteoporosis. [7][8][9][10][11][12][13][14][15][16] We decided to do this study as this is quite obvious from the above discussion that HRT is either not prescribed due to health scare or there is gross ignorance on the part of menopausal women. So, the aim of the study was to know the awareness of menopause and HRT among women attending OPD of University teaching hospital.…”

Section: Introductionmentioning

confidence: 99%

Awareness of menopause and HRT among women attending OPD of University teaching hospital

Pandey

2014

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONMenopause is a physiological process which happens with gradual decline in ovarian function. Menopause is the end of reproductive life. The average age of menopause is 51 years among the women internationally. 1Menopause is becoming important public health issue. In this modern world the life expectancy is gradually increasing, therefore the proportion of women who are menopausal is also increasing. In 1960, the world population of females over the age of 60 years was approximately 250 million, but it is expected that by the year 2030 population of perimenopausal or postmenopausal women might be 1.2 billion. This is quite an extraordinary increase. 2In the developed world women on average is expected to spend approximately one third of her life as postmenopausal women. Life expectancy has also remarkably increased in the developing world. So it is likely that women in India will also spend approximately one third to one fourth of their life as postmenopausal women. 3Attitude determines the way we deal with our problems in difficult situations. Massachusetts women health study did a longitudinal study on more than 2000 women between 45-55 years. This study showed that negative attitude towards menopause leads to poor outcome. ABSTRACT Background:The aim of this study was to find the awareness of menopause and Hormone Replacement Therapy (HRT) among women attending gynaecology outpatient in a university teaching hospital. Methods: Study was conducted in the outpatients department of women attending gynaecology OPD in Sir Sunder Lal hospital, institute of medical sciences, Banaras Hindu University, Varanasi. It was done prospectively. Their awareness of menopause and HRT was enquired. Period of study was January 2013-December 2013. 67 women participated in this questionnaire survey. Socio-demographic characteristics, their knowledge of menopause and awareness of HRT were enquired. Results: Age range of participants was 35-55. The age range of menopause was 45-55. 80% of women were from low socioeconomic status. 90% were illiterate. 60% of women have heard about menopause. 40 % of women were aware of symptoms of menopause. Only 2% of women were aware of HRT. 66 % of women were sexually active. Conclusions: Relatively good number women were not aware of menopause. Majority of women were not aware of HRT.

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“…20 -22 Banks et al evaluated the impact of HT on FP recall in the National Health Service (NHS) Breast Screening Program in the United Kingdom and found higher FP recall rates among current users of HT compared with nonusers (OR 1.6; 95% CI 1.5-1.8). 21 However, the researchers also found an increased odds of FP recall in past users of HT (OR 1.2; 95% CI 1.1-1.4) that decreased with time since last use but remained high even among women ceasing HT within the past 5 years. Differences in FP recall risk with HT by age or type of HT were not reported in this study of 50-to 64-year-old women.…”

Section: Discussionmentioning

confidence: 94%

“…Differences in FP recall risk with HT by age or type of HT were not reported in this study of 50-to 64-year-old women. 21 Findings from another study conducted in the United Kingdom were suggestive of an increase in overall recall among HT users (37% higher) compared with nonusers. 20 There was also a nonsignificant increase in recall among women who initiated HT within 36 months of screening as compared with women who initiated more than 36 months before screening.…”

Section: Discussionmentioning

confidence: 94%

“…1,18,19 HT can lead to missed breast cancer cases or increases in false-positive (FP) recall for additional breast evaluation, 20 -22 as well as anxiety among disease-free women. 23,24 Information is very limited on the impact of HT use at mammography screening on recall rates and downstream costs, 20,21 especially in the United States 22 where recall rates (percentage of mammograms judged to be abnormal) are higher than many other countries. 25 More information is needed to help women and their providers understand the effects of HT on all aspects of care, including risk for unneeded procedures and downstream medical expenses.…”

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confidence: 99%

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Impact of Hormone Therapy on False-Positive Recall and Costs Among Women Undergoing Screening Mammography

et al. 2006

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Impact of use of hormone replacement therapy on false positive recall in the NHS breast screening programme: results from the million women study

Cited by 28 publications

References 4 publications

Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study

Influence of personal characteristics of individual women on sensitivity and specificity of mammography in the Million Women Study: cohort study

Awareness of menopause and HRT among women attending OPD of University teaching hospital

Impact of Hormone Therapy on False-Positive Recall and Costs Among Women Undergoing Screening Mammography

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