Harms and benefits of mammographic screening for breast cancer in Brazil.
<h4>Introduction</h4>In the absence of evidence on the effect of mammographic screening on overall mortality, comparing the number of deaths avoided with the number of deaths caused by screening would be ideal, but the only existing models of this type adopt a very narrow definition of h...
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2024-01-01
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| author | Arn Migowski Paulo Nadanovsky Cid Manso de Mello Vianna |
| author_facet | Arn Migowski Paulo Nadanovsky Cid Manso de Mello Vianna |
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| description | <h4>Introduction</h4>In the absence of evidence on the effect of mammographic screening on overall mortality, comparing the number of deaths avoided with the number of deaths caused by screening would be ideal, but the only existing models of this type adopt a very narrow definition of harms. The objective of the present study was to estimate the number of deaths prevented and induced by various mammography screening protocols in Brazil.<h4>Methods</h4>A simulation study of cohorts of Brazilian women screened, considering various age groups and screening interval protocols, was performed based on life tables. The number of deaths avoided and caused by screening was estimated, as was the absolute risk reduction, the number needed to invite for screening-NNS, the net benefit of screening, and the ratio of "lives saved" to "lives lost". Nine possible combinations of balances between benefits and harms were performed for each protocol, in addition to other sensitivity analyses.<h4>Results and conclusions</h4>The most efficient protocol was biennial screening from 60 to 69 years of age, with almost three times more deaths avoided than biennial screening from 50 to 59 years of age, with a similar number of deaths avoided by biennial screening from 50 to 69 years of age and with the greatest net benefit. Compared with the best scenario of annual screening from 40 to 49 years of age, the NNS of the protocol with biennial screening from 60 to 69 years of age was three-fold lower. Even in its best scenario, the addition of annual screening from 40 to 49 years of age to biennial screening from 50 to 69 years of age results in a decreased net benefit. However, even in the 50-69 year age group, the estimated reduction in breast cancer mortality for Brazil was half that estimated for the United Kingdom. |
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| spelling | doaj-art-c2167e018cc944889fc6c3d1e006e70e2025-08-20T02:10:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01191e029704810.1371/journal.pone.0297048Harms and benefits of mammographic screening for breast cancer in Brazil.Arn MigowskiPaulo NadanovskyCid Manso de Mello Vianna<h4>Introduction</h4>In the absence of evidence on the effect of mammographic screening on overall mortality, comparing the number of deaths avoided with the number of deaths caused by screening would be ideal, but the only existing models of this type adopt a very narrow definition of harms. The objective of the present study was to estimate the number of deaths prevented and induced by various mammography screening protocols in Brazil.<h4>Methods</h4>A simulation study of cohorts of Brazilian women screened, considering various age groups and screening interval protocols, was performed based on life tables. The number of deaths avoided and caused by screening was estimated, as was the absolute risk reduction, the number needed to invite for screening-NNS, the net benefit of screening, and the ratio of "lives saved" to "lives lost". Nine possible combinations of balances between benefits and harms were performed for each protocol, in addition to other sensitivity analyses.<h4>Results and conclusions</h4>The most efficient protocol was biennial screening from 60 to 69 years of age, with almost three times more deaths avoided than biennial screening from 50 to 59 years of age, with a similar number of deaths avoided by biennial screening from 50 to 69 years of age and with the greatest net benefit. Compared with the best scenario of annual screening from 40 to 49 years of age, the NNS of the protocol with biennial screening from 60 to 69 years of age was three-fold lower. Even in its best scenario, the addition of annual screening from 40 to 49 years of age to biennial screening from 50 to 69 years of age results in a decreased net benefit. However, even in the 50-69 year age group, the estimated reduction in breast cancer mortality for Brazil was half that estimated for the United Kingdom.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0297048&type=printable |
| spellingShingle | Arn Migowski Paulo Nadanovsky Cid Manso de Mello Vianna Harms and benefits of mammographic screening for breast cancer in Brazil. PLoS ONE |
| title | Harms and benefits of mammographic screening for breast cancer in Brazil. |
| title_full | Harms and benefits of mammographic screening for breast cancer in Brazil. |
| title_fullStr | Harms and benefits of mammographic screening for breast cancer in Brazil. |
| title_full_unstemmed | Harms and benefits of mammographic screening for breast cancer in Brazil. |
| title_short | Harms and benefits of mammographic screening for breast cancer in Brazil. |
| title_sort | harms and benefits of mammographic screening for breast cancer in brazil |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0297048&type=printable |
| work_keys_str_mv | AT arnmigowski harmsandbenefitsofmammographicscreeningforbreastcancerinbrazil AT paulonadanovsky harmsandbenefitsofmammographicscreeningforbreastcancerinbrazil AT cidmansodemellovianna harmsandbenefitsofmammographicscreeningforbreastcancerinbrazil |