Evidence map›Paper›PMID 36762395›Full record

ArticleJournal of medical screening2023

Overcoming barriers: Modelling the effect of potential future changes of organized breast cancer screening in Italy.

Nadine Zielonke, Carlo Senore, Antonio Ponti, Marcell Csanadi, Harry J de Koning, Eveline A M Heijnsdijk, Nicolien T van Ravesteyn

Abstract read
In one paragraph

Article in Journal of medical screening, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Nadine ZielonkeDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Carlo SenoreEpidemiology and screening Unit - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy.ORCID 0000-0003-1023-7477
Antonio PontiEpidemiology and screening Unit - CPO, University Hospital Città della Salute e della Scienza, Turin, Italy.
Marcell CsanadiSyreon Research Institute, Budapest, Hungary.ORCID 0000-0002-5724-639X
Harry J de KoningDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.ORCID 0000-0003-4682-3646
Eveline A M HeijnsdijkDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Nicolien T van RavesteynDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.ORCID 0000-0003-3531-466X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOrganized breast cancer screening may not achieve its full potential due to organizational and cultural barriers. In Italy, two identified barriers were low attendance in Southern Italy and, in Italy as a whole, underscreening and overscreening in parts of the eligible population. The objective of this study was to identify potential changes to overcome these barriers and to quantify their costs and effects.

methodsTo assess the impact of potential measures to improve breast cancer screening in Italy, we performed an evaluation of costs and effects for increasing adherence for Southern Italy and harmonizing screening intervals (biennial screening) for the whole of Italy, using an online tool (EU-TOPIA evaluation tool) based on the MIcrosimulation SCreening ANalysis (MISCAN) model.

resultsIncreasing adherence in Southern Italy through investing in mobile screening units has an acceptable cost-effectiveness ratio of €9531 per quality-adjusted life year gained. Harmonizing the screening interval by investing in measures to reduce opportunistic screening and simultaneously investing in mobile screening units to reduce underscreening is predicted to gain 1% fewer life-years, while saving 19% of total screening costs compared to the current situation.

conclusionsIncreasing adherence in Southern Italy and harmonizing the screening interval could result in substantial improvements at acceptable costs, or in the same benefits at lower costs. This example illustrates a systematic approach that can be easily applied to other European countries, as the online tools can be used by stakeholders to quantify effects and costs of a broad range of specific barriers, and ways to overcome them.

Indexed as

Breast NeoplasmsCost-Benefit AnalysisEarly Detection of CancerFemaleHumansItalyMass ScreeningadherenceBreast cancer screeningcost-effectivenessItalymicrosimulationscreening interval

Identifiers

PMID36762395
PMCPMC10399099

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Registered trials

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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.