programas cribado cancer
INICIO / CÁNCER DE MAMA / ACTUALIZACIÓN BIBLIOGRÁFICA / NOTA BIBLIOGRáFICA CRIBADO C MAMA 2014-11

Nota bibliográfica cribado c mama 2014-11

Lousdal ML, Kristiansen IS, Møller B, Støvring H. Trends in breast cancer stage distribution before, during and after introduction of a screening programme in Norway. Eur J Public Health. 2014;24(6):1016–21. Available from: http://eurpub.oxfordjournals.org/content/24/6/1016.abstract.

Conclusion: Incidence of localized breast cancer increased significantly among women aged 50–69 years old after introduction of screening, while the incidence of more advanced cancers was not reduced in the same period when compared to the younger unscreened age group.

Andersen SB, Törnberg S, Lynge E, Von Euler-Chelpin M, Njor SH. A simple way to measure the burden of interval cancers in breast cancer screening. BMC Cancer. London; 2014;14(1):782. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219107/. doi: 10.1186/1471-2407-14-782.

CONCLUSION: This alternate measure seems to capture the burden of interval cancers just as well as the traditional PICR, without need for the increasingly difficult estimation of background incidence, making it a more accessible tool when evaluating mammography screening program performance.

AL Mousa DS, Mello-Thoms C, Ryan EA, Lee WB, Pietrzyk MW, Reed WM, et al. Mammographic Density and Cancer Detection: Does Digital Imaging Challenge our Current Understanding?. Acad Radiol. 2014;21(11):1377–85. Available from: http://www.sciencedirect.com/science/article/pii/S1076633214002323. doi: http://dx.doi.org/10.1016/j.acra.2014.06.004.

Conclusions Increased mammographic density improves the performance of experienced radiologists when using digital mammograms. This finding, which does not align with those previously reported for film screen systems, may be because of windowing/leveling opportunities available with digital images.

WHO. WHO position paper on mammography screening. Geneva:Switzerland; 2014.
 
Recommendations by age group and resource setting 1. Women aged 50−69 years 1.1 Well-resourced settings In well-resourced settings, WHO recommends 1 organized, populationbased mammography screening programmes for women aged 50−69 years if the conditions for implementing an organized programme specified in this guide 2 are met by the health-care system, and if shared decisionmaking strategies are implemented so that women’s decisions are consistent with their values and preferences. (Strong recommendation based on moderate quality evidence) WHO suggests a screening interval of two years. (Conditional recommendation based on low quality evidence) 1.2 Limited resource settings with relatively strong health systems In limited resource settings with relatively strong health systems, WHO suggests 3 considering an organized, population-based mammography screening programme for women aged 50−69 years only if the conditions for implementing an organized programme specified in this guide 4 are met by the health-care system, and if shared decision-making strategies are implemented so that women’s decisions are consistent with their values and preferences. (Conditional recommendation based on moderate quality evidence) WHO suggests a screening interval of two years. (Conditional recommendation based on low quality evidence) 1.3 Limited resource settings with weak health systems In limited resource settings with weak health systems, where the majority of women with breast cancer are diagnosed in late stages and mammography screening is not cost-effective and feasible, early diagnosis of breast cancer through universal access of women with symptomatic lesions to prompt and effective diagnosis and treatment should be high 1. According to GRADE, “recommend” is used when there is a strong recommendation. 2. See Box 1, page 8. 3. According to GRADE, “suggest” is used when there is a conditional recommendation. 4. See Box 1, page 8. 12 WHO position paper on mammography screening on the public health agenda (WHO, 2013). Clinical breast examination, a low-cost screening method, seems to be a promising approach for these settings and could be implemented when the necessary evidence from ongoing studies becomes available (Sankaranarayanan et al., 2011). 2. Women aged 40−49 years 2.1 Well-resourced settings In well-resourced settings, WHO suggests an organized, population-based screening programme for women aged 40−49 years only if such programme is conducted in the context of…

Tabár L, Yen AM-F, Wu WY-Y, Chen SL-S, Chiu SY-H, Fann JC-Y, et al. Insights from the Breast Cancer Screening Trials: How Screening Affects the Natural History of Breast Cancer and Implications for Evaluating Service Screening Programs. Breast J. 2014;n/a – n/a. Available from: http://dx.doi.org/10.1111/tbj.12354. doi: 10.1111/tbj.12354.

This study provides evidence that the average mortality reduction in all the trials underestimates the true mortality reduction, and that substantially greater breast cancer mortality reductions can be expected in screening programs that are effective in reducing advanced stage breast cancer. In addition, monitoring the incidence of advanced stage breast cancer in an ongoing screening program can provide a sensitive and early indicator of the subsequent mortality from the disease.

Bargallo X, Santamaria G, Del Amo M, Arguis P, Rios J, Grau J, et al. Single reading with computer-aided detection performed by selected radiologists in a breast cancer screening program.Eur J Radiol. Ireland; 2014;83(11):2019–23. doi: 10.1016/j.ejrad.2014.08.010. PMID: 25193778.

CONCLUSIONS: The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD, at the cost of a moderate increase of the recall rate mainly related to the lack of arbitration.

Altobelli E, Lattanzi A. Breast cancer in European Union: an update of screening programmes as of March 2014 (review). Int J Oncol. Greece; 2014;45(5):1785–92. doi: 10.3892/ijo.2014.2632. PMID: 25174328.

 Breast cancer, a major cause of female morbidity and mortality, is a global health problem; 2008 data show an incidence of ~450,000 new cases and 140,000 deaths (mean incidence rate 70.7 and mortality rate 16.7, world age-standardized rate per 100,000 women) in European Union Member States. Incidence rates in Western Europe are among the highest in the world. We review the situation of BC screening programmes in European Union. Up to date information on active BC screening programmes was obtained by reviewing the literature and searching national health ministries and cancer service websites. Although BC screening programmes are in place in nearly all European Union countries there are still considerable differences in target population coverage and age and in the techniques deployed. Screening is a mainstay of early BC detection whose main weakness is the rate of participation of the target population. National policies and healthcare planning should aim at maximizing participation in controlled organized screening programmes by identifying and lowering any barriers to adhesion, also with a view to reducing healthcare costs.
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