Abstract
Objective. - To determine the efficacy of screening mammography by age, number of mammographic views per screen, screening interval, and duration of follow-up. Design. - Literature review and meta-analysis. Data Identification and Analysis. - Literature search of English-language studies reported from January 1966 to October 31, 1993, using MEDLINE, manual literature review, and consultation with experts. A total of 13 studies were selected, and their results were combined using meta-analytic techniques based on the assumption of fixed effects. Main Results. - The overall summary relative risk (RR) estimate for breast cancer mortality for women aged 50 to 74 years undergoing screening mammography compared with those who did not was 0.74 (95% confidence interval [CI], 0.66 to 0.83). The magnitude of the benefit in this age group was similar regardless of number of mammographic views per screen, screening interval, or duration of follow-up. In contrast, none of the summary RR estimates for women aged 40 to 49 years was significantly less than 1.0, irrespective of screening intervention or duration of follow-up. The overall summary RR estimate in women aged 40 to 49 years was 0.93 (95% CI, 0.76 to 1.13); the summary RR estimate for those studies that used two- view mammography was 0.87 (95% CI, 0.68 to 1.12) compared with 1.02 (96% CI, 0.73 to 1.44) for those studies that used one-view mammography, and for those studies with 7 to 9 years of follow-up, the summary RR estimate was 1.02 (95% CI, 0.82 to 1.27) compared with 0.83 (95% CI, 0.65 to 1.06) for those studies with 10 to 12 years of follow-up. Conclusion. - Screening mammography significantly reduces breast cancer mortality in women aged 50 to 74 years after 7 to 9 years of follow-up, regardless of screening interval or number of mammographic views per screen. There is no reduction in breast cancer mortality in women aged 40 to 49 years after 7 to 9 years of follow-up. Screening mammography may be effective in reducing breast cancer mortality in women aged 40 to 49 years after 10 to 12 years of follow-up, but the same benefit could probably be achieved by beginning screening at menopause or 50 years of age.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 149-154 |
| Number of pages | 6 |
| Journal | Journal of the American Medical Association |
| Volume | 273 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jan 11 1995 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
Efficacy of screening mammography : A meta-analysis. / Kerlikowske, Karla; Grady, Deborah; Rubin, Susan M.; Sandrock, Christian E; Ernster, Virginia L.
In: Journal of the American Medical Association, Vol. 273, No. 2, 11.01.1995, p. 149-154.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Efficacy of screening mammography
T2 - A meta-analysis
AU - Kerlikowske, Karla
AU - Grady, Deborah
AU - Rubin, Susan M.
AU - Sandrock, Christian E
AU - Ernster, Virginia L.
PY - 1995/1/11
Y1 - 1995/1/11
N2 - Objective. - To determine the efficacy of screening mammography by age, number of mammographic views per screen, screening interval, and duration of follow-up. Design. - Literature review and meta-analysis. Data Identification and Analysis. - Literature search of English-language studies reported from January 1966 to October 31, 1993, using MEDLINE, manual literature review, and consultation with experts. A total of 13 studies were selected, and their results were combined using meta-analytic techniques based on the assumption of fixed effects. Main Results. - The overall summary relative risk (RR) estimate for breast cancer mortality for women aged 50 to 74 years undergoing screening mammography compared with those who did not was 0.74 (95% confidence interval [CI], 0.66 to 0.83). The magnitude of the benefit in this age group was similar regardless of number of mammographic views per screen, screening interval, or duration of follow-up. In contrast, none of the summary RR estimates for women aged 40 to 49 years was significantly less than 1.0, irrespective of screening intervention or duration of follow-up. The overall summary RR estimate in women aged 40 to 49 years was 0.93 (95% CI, 0.76 to 1.13); the summary RR estimate for those studies that used two- view mammography was 0.87 (95% CI, 0.68 to 1.12) compared with 1.02 (96% CI, 0.73 to 1.44) for those studies that used one-view mammography, and for those studies with 7 to 9 years of follow-up, the summary RR estimate was 1.02 (95% CI, 0.82 to 1.27) compared with 0.83 (95% CI, 0.65 to 1.06) for those studies with 10 to 12 years of follow-up. Conclusion. - Screening mammography significantly reduces breast cancer mortality in women aged 50 to 74 years after 7 to 9 years of follow-up, regardless of screening interval or number of mammographic views per screen. There is no reduction in breast cancer mortality in women aged 40 to 49 years after 7 to 9 years of follow-up. Screening mammography may be effective in reducing breast cancer mortality in women aged 40 to 49 years after 10 to 12 years of follow-up, but the same benefit could probably be achieved by beginning screening at menopause or 50 years of age.
AB - Objective. - To determine the efficacy of screening mammography by age, number of mammographic views per screen, screening interval, and duration of follow-up. Design. - Literature review and meta-analysis. Data Identification and Analysis. - Literature search of English-language studies reported from January 1966 to October 31, 1993, using MEDLINE, manual literature review, and consultation with experts. A total of 13 studies were selected, and their results were combined using meta-analytic techniques based on the assumption of fixed effects. Main Results. - The overall summary relative risk (RR) estimate for breast cancer mortality for women aged 50 to 74 years undergoing screening mammography compared with those who did not was 0.74 (95% confidence interval [CI], 0.66 to 0.83). The magnitude of the benefit in this age group was similar regardless of number of mammographic views per screen, screening interval, or duration of follow-up. In contrast, none of the summary RR estimates for women aged 40 to 49 years was significantly less than 1.0, irrespective of screening intervention or duration of follow-up. The overall summary RR estimate in women aged 40 to 49 years was 0.93 (95% CI, 0.76 to 1.13); the summary RR estimate for those studies that used two- view mammography was 0.87 (95% CI, 0.68 to 1.12) compared with 1.02 (96% CI, 0.73 to 1.44) for those studies that used one-view mammography, and for those studies with 7 to 9 years of follow-up, the summary RR estimate was 1.02 (95% CI, 0.82 to 1.27) compared with 0.83 (95% CI, 0.65 to 1.06) for those studies with 10 to 12 years of follow-up. Conclusion. - Screening mammography significantly reduces breast cancer mortality in women aged 50 to 74 years after 7 to 9 years of follow-up, regardless of screening interval or number of mammographic views per screen. There is no reduction in breast cancer mortality in women aged 40 to 49 years after 7 to 9 years of follow-up. Screening mammography may be effective in reducing breast cancer mortality in women aged 40 to 49 years after 10 to 12 years of follow-up, but the same benefit could probably be achieved by beginning screening at menopause or 50 years of age.
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U2 - 10.1001/jama.273.2.149
DO - 10.1001/jama.273.2.149
M3 - Article
C2 - 7799496
AN - SCOPUS:0028817211
VL - 273
SP - 149
EP - 154
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
SN - 0002-9955
IS - 2
ER -