Evidence map›Paper›PMID 25537022›Full record

ArticleJournal of the American Geriatrics Society2015

A prospective study of the use and effects of screening mammography in women aged 70 and older.

Pamela M Vacek, Joan M Skelly

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Surveillance mammography in older women-should we press on?Journal of the National Cancer Institute · 2026
    Article
  4. Article
  5. Review
  6. Review
  7. Variations Between Sources of Social Support and Cancer Screen Behaviors in U.S. Chinese Older Adults.The journals of gerontology. Series A, Biological sciences and medical sciences · 2017
    Article
  8. White-Black Differences in Cancer Incidence, Stage at Diagnosis, and Survival among Adults Aged 85 Years and Older in the United States.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2016
    Article
  9. Review
  10. Review
  11. Breast Cancer Screening in Older Women: The Importance of Shared Decision Making.Journal of the American Board of Family Medicine : JABFM
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

Pamela M VacekMedical Biostatistics Unit, College of Medicine, University of Vermont, Burlingon, Vermont; Department of Pathology, College of Medicine, University of Vermont, Burlingon, Vermont; Vermont Cancer Center, University of Vermont and Fletcher Allen Health Care, Burlington, Vermont.
Joan M Skelly

Funding

VERMONT BREAST CANCER SURVEILLANCE SYSTEMU01CA070013 · NCI · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI GELLER, BERTA M · 1995 to 2011
$6.7M
NCI NIH HHS U01 CA070013NCI NIH HHS UO1-CA70013
6 · The paper itself

Abstract

objectivesTo prospectively examine how age and comorbidity affect screening mammography use, cancer detection, and overall survival.

designProspective, with median follow-up of 10.2 years.

settingA population-based cohort of Vermont women with data in the Vermont Breast Cancer Surveillance System.

participantsWomen aged 70 and older with no history of breast cancer (N = 20,697). MEASUREMENTS: Rates of screening, diagnostic procedure use, and breast cancer diagnosis were examined according to age and comorbidity. The effect of breast cancer on overall survival was assessed in relation to detection mode, tumor characteristics, and treatment.

resultsScreening declined 9% per year after age 70 and 18% with each unit increase in comorbidity score, with corresponding increases in clinically detected breast cancer. Invasive cancer was associated with greater overall mortality (screen detected: hazard ratio (HR) = 1.22, 95% confidence interval (CI) = 1.07-1.40; clinically detected: HR = 1.68, 95% CI = 1.43-1.96). The latter HR reflects a much greater absolute risk of death for women in a population with high baseline mortality. Use of breast-conserving surgery as the only treatment for Stage I cancer increased markedly with age and was associated with shorter overall survival than radiation or mastectomy (relative risk = 2.23, 95% CI = 1.42-3.47).

conclusionLower screening mammography use by older women is associated with more clinically detected breast cancers, which are associated with poorer survival. Treatment received for early-stage cancer influences the effect of screening on survival.

Indexed as

AgedAged, 80 and overBreast NeoplasmsComorbidityEarly Detection of CancerFemaleFollow-Up StudiesHumansIncidenceMammographyMass ScreeningPrevalenceProspective StudiesSurvival RateVermontbreast cancerelderlyscreening mammographysurvival

Identifiers

PMID25537022
PMCPMC4300281

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.