ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2013
Incidence of breast cancer and estimates of overdiagnosis after the initiation of a population-based mammography screening program.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Quantifying and monitoring overdiagnosis in cancer screening: a systematic review of methods.BMJ (Clinical research ed.) · 2015Pooled it
- Overdiagnosis Due to Screening Mammography for Breast Cancer among Women Aged 40 Years and Over: A Systematic Review and Meta-Analysis.Journal of personalized medicine · 2023Review
- Screening Mammography Outcomes: Risk of Breast Cancer and Mortality by Comorbidity Score and Age.Journal of the National Cancer Institute · 2020Article
- Article
- Cancer Risk and Multiple Sclerosis: Evidence From a Large Italian Cohort.Frontiers in neurology · 2019Article
- Overdiagnosis in primary care: framing the problem and finding solutions.BMJ (Clinical research ed.) · 2018Review
- Deep Synthesis of Realistic Medical Images: A Novel Tool in Clinical Research and Training.Frontiers in neuroinformatics · 2018Article
- Cancer risk among patients with multiple sclerosis: A cohort study in Isfahan, Iran.Caspian journal of internal medicine · 2017Article
- Cost-Effectiveness of Three Rounds of Mammography Breast Cancer Screening in Iranian Women.Iranian journal of cancer prevention · 2016Article
- Mammography, Martin Yaffe, and me: response and appreciation.Current oncology (Toronto, Ont.) · 2015Article
- Beyond the mammography debate: a moderate perspective.Current oncology (Toronto, Ont.) · 2015Article
- Diagnostic and therapeutic path of breast cancer: effectiveness, appropriateness, and costs--results from the DOCMa study.Clinical interventions in aging · 2015Article
- The increase in cancer prevalence and hospital burden in Western Australia, 1992-2011.Population health metrics · 2014Article
- Review
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Authors and funding
2 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThere has been growing interest in the overdiagnosis of breast cancer as a result of mammography screening. We report incidence rates in British Columbia before and after the initiation of population screening and provide estimates of overdiagnosis.
methodsWe obtained the numbers of breast cancer diagnoses from the BC Cancer Registry and screening histories from the Screening Mammography Program of BC for women aged 30-89 years between 1970 and 2009. We calculated age-specific rates of invasive breast cancer and ductal carcinoma in situ. We compared these rates by age, calendar period and screening participation. We obtained 2 estimates of overdiagnosis from cumulative cancer rates among women between the ages of 40 and 89 years: the first estimate compared participants with nonparticipants; the second estimate compared observed and predicted population rates.
resultsWe calculated participation-based estimates of overdiagnosis to be 5.4% for invasive disease alone and 17.3% when ductal carcinoma in situ was included. The corresponding population-based estimates were -0.7% and 6.7%. Participants had higher rates of invasive cancer and ductal carcinoma in situ than nonparticipants but lower rates after screening stopped. Population incidence rates for invasive cancer increased after 1980; by 2009, they had returned to levels similar to those of the 1970s among women under 60 years of age but remained elevated among women 60-79 years old. Rates of ductal carcinoma in situ increased in all age groups.
interpretationThe extent of overdiagnosis of invasive cancer in our study population was modest and primarily occurred among women over the age of 60 years. However, overdiagnosis of ductal carcinoma in situ was elevated for all age groups. The estimation of overdiagnosis from observational data is complex and subject to many influences. The use of mammography screening in older women has an increased risk of overdiagnosis, which should be considered in screening decisions.
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