Observational studyCancer2020
New mammography screening performance metrics based on the entire screening episode.
Observational study in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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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.
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.
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Who cites it
15 citing papers in PubMed, 20 citations in OpenAlex.
- Use of population-based cancer registry data to evaluate organized breast cancer screening programmes in Europe by mode of detection: a scoping review.European journal of public health · 2026Article
- Breast density and risk of breast cancer: masking and detection bias.American journal of epidemiology · 2025Article
- Disparities in Standard-of-Care, Advanced, and Same-Day Diagnostic Services among Patients with Abnormal Screening Mammography.Radiology · 2025Article
- Performance Metrics of Mammography Screening Programmes in Primary Health Care Centres in Bahrain.International journal of women's health · 2025Article
- Relative Timing of Mammography and MRI for Breast Cancer Screening: Impact on Performance Evaluation.Journal of the American College of Radiology : JACR · 2024Article
- Screening mammography performance according to breast density: a comparison between radiologists versus standalone intelligence detection.Breast cancer research : BCR · 2024Article
- Supplemental magnetic resonance imaging plus mammography compared with magnetic resonance imaging or mammography by extent of breast density.Journal of the National Cancer Institute · 2024Article
- Risk of cancer versus risk of cancer diagnosis? Accounting for diagnostic bias in predictions of breast cancer risk by race and ethnicity.Journal of medical screening · 2023Article
- Breast cancer risk characteristics of women undergoing whole-breast ultrasound screening versus mammography alone.Cancer · 2023Article
- Article
- Cumulative 6-Year Risk of Screen-Detected Ductal Carcinoma In Situ by Screening Frequency.JAMA network open · 2023Article
- Article
- Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort.Annals of internal medicine · 2022Article
- Prioritizing breast imaging services during the COVID pandemic: A survey of breast imaging facilities within the Breast Cancer Surveillance Consortium.Preventive medicine · 2021Article
- Digital Mammography and Breast Tomosynthesis Performance in Women with a Personal History of Breast Cancer, 2007-2016.Radiology · 2021Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundEstablished mammography screening performance metrics use the initial screening mammography assessment because they were developed for radiologist performance auditing, yet these metrics are frequently used to inform health policy and screening decision making. The authors have developed new performance metrics based on the final assessment that consider the entire screening episode, including diagnostic workup.
methodsThe authors used data from 2,512,577 screening episodes during 2005-2017 at 146 facilities in the United States participating in the Breast Cancer Surveillance Consortium. Screening performance metrics based on the final assessment of the screening episode were compared with conventional metrics defined with the initial assessment. Results were also stratified by breast density and breast cancer risk.
resultsThe cancer detection rates were similar for the final assessment (4.1 per 1000; 95% confidence interval [CI], 3.8-4.3 per 1000) and the initial assessment (4.1 per 1000; 95% CI, 3.9-4.3 per 1000). The interval cancer rate was 12% higher when it was based on the final assessment (0.77 per 1000; 95% CI, 0.71-0.83 per 1000) versus the initial assessment (0.69 per 1000; 95% CI, 0.64-0.74 per 1000), and this resulted in a modest difference in sensitivity (84.1% [95% CI, 83.0%-85.1%] vs 85.7% [95% CI, 84.8%-86.6%], respectively). Absolute differences in the interval cancer rate between final and initial assessments increased with breast density and breast cancer risk (eg, a difference of 0.29 per 1000 for women with extremely dense breasts and a 5-year risk >2.49%).
conclusionsEstablished screening performance metrics underestimate the interval cancer rate of a mammography screening episode, particularly for women with dense breasts or an elevated breast cancer risk. Women, clinicians, policymakers, and researchers should use final-assessment performance metrics to support informed screening decisions.
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Registered trials
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.