For example , mammography screening does not seem to create anxiety in women who are given a clear result after a mammogram .
The incidence of breast cancer and mortality increases with age , and the GDG extrapolated that the absolute health benefits are greater in women aged 45 to 49 than those aged 40 to 44 years .
However , for the 45- to 49-year age group , the higher breast cancer incidence and mortality compared with women between the ages of 40 and 44 , as well as observational evidence showing a greater benefit in this age group ( 33 ) , led the GDG to judge that the balance of health effects probably favors screening , although the required re sources for screening likely differ across setting s ( 34 , 35 ) .
Other EtD criteria also were generally in favor of implementing organized mammography screening in this age group .
Despite intensified efforts by the European Council since 2003 , the implementation of organized , population -based mammography screening is not uniform across Europe and depends greatly on the policies in place in different countries , the organization of health care , and available re sources ( 1 ) .
Since the last edition of the European Guidelines on Breast Cancer Screening and Diagnosis was published in 2006 ( 2 ) , new evidence regarding breast cancer and innovation in guideline methodology prompted the European Commission Initiative on Breast Cancer ( ECIBC ) to develop new evidence -based recommendations ( in short , the European Breast Guidelines ) .
These guidelines inform women , health professionals , and policymakers about important questions related to organized mammography screening and breast cancer diagnosis , but recommendations may apply in context s in which organized screening programs are not in place .
Women generally consider these undesirable effects acceptable ( low certainty of evidence ) , and a systematic review suggested that women place a relatively low value on the psychosocial and physical effects of false-positive results and overdiagnosis ; however , some studies raised concerns about whether women fully underst and the result ing implication s ( 15 ) .
How Often Should Women Attend an Organized Mammography Screening Program ?
Effect of mammographic screening from age 40 years on breast cancer mortality in the UK Age trial at 17 years' follow-up: a randomised controlled trial.
BACKGROUND Age-specific effects of mammographic screening , and the timing of such effects , are a matter of debate . The results of the UK Age trial , which compared the effect of invitation to annual mammographic screening from age 40 years with commencement of screening at age 50 years on breast cancer mortality , have been reported at 10 years of follow-up and showed no significant difference in mortality between the trial groups . Here , we report the results of the UK Age trial after 17 years of follow-up . METHODS Women aged 39 - 41 from 23 UK NHS Breast Screening Programme units years were r and omly assigned by individual r and omisation ( 1:2 ) to either an intervention group offered annual screening by mammography up to and including the calendar year of their 48th birthday or to a control group receiving usual medical care ( invited for screening at age 50 years and every 3 years thereafter ) . Both groups were stratified by general practice . We compared breast cancer incidence and mortality by time since r and omisation . Analyses included all women r and omly assigned who could be traced with the National Health Service Central Register and who had not died or emigrated before entry . The primary outcome measures were mortality from breast cancer ( defined as deaths with breast cancer coded as the underlying cause of death ) and breast cancer incidence , including in-situ , invasive , and total incidence . Because there is an interest in the timing of the mortality effect , we analysed the results in different follow-up periods . This trial is registered , number IS RCT N24647151 . FINDINGS Between Oct 14 , 1990 , and Sept 25 , 1997 , 160 921 participants were r and omly assigned ; 53 883 women in the intervention group and 106 953 assigned to usual medical care were included in this analysis . After a median follow-up of 17 years ( IQR 16·8 - 18·8 ) , the rate ratio ( RR ) for breast cancer mortality was 0·88 ( 95 % CI 0·74 - 1·04 ) from tumours diagnosed during the intervention phase . A significant reduction in breast cancer mortality was noted in the intervention group compared with the control group in the first 10 years after diagnosis ( RR 0·75 , 0·58 - 0·97 ) but not thereafter ( RR 1·02 , 0·80 - 1·30 ) from tumours diagnosed during the intervention phase . The overall breast cancer incidence during 17 year follow-up was similar between the intervention group and the control group ( RR 0·98 , 0·93 - 1·04 ) . INTERPRETATION Our results support an early reduction in mortality from breast cancer with annual mammography screening in women aged 40 - 49 years . Further data are needed to fully underst and long-term effects . Cumulative incidence figures suggest at worst a small amount of overdiagnosis . FUNDING National Institute for Health Research Health Technology Assessment programme and the American Cancer Society . Past funding was received from the Medical Research Council , Cancer Research UK , the UK Department of Health , and the US National Cancer Institute
For example , mammography screening does not seem to create anxiety in women who are given a clear result after a mammogram .
The incidence of breast cancer and mortality increases with age , and the GDG extrapolated that the absolute health benefits are greater in women aged 45 to 49 than those aged 40 to 44 years .
However , for the 45- to 49-year age group , the higher breast cancer incidence and mortality compared with women between the ages of 40 and 44 , as well as observational evidence showing a greater benefit in this age group ( 33 ) , led the GDG to judge that the balance of health effects probably favors screening , although the required re sources for screening likely differ across setting s ( 34 , 35 ) .
Other EtD criteria also were generally in favor of implementing organized mammography screening in this age group .
Despite intensified efforts by the European Council since 2003 , the implementation of organized , population -based mammography screening is not uniform across Europe and depends greatly on the policies in place in different countries , the organization of health care , and available re sources ( 1 ) .
Since the last edition of the European Guidelines on Breast Cancer Screening and Diagnosis was published in 2006 ( 2 ) , new evidence regarding breast cancer and innovation in guideline methodology prompted the European Commission Initiative on Breast Cancer ( ECIBC ) to develop new evidence -based recommendations ( in short , the European Breast Guidelines ) .
These guidelines inform women , health professionals , and policymakers about important questions related to organized mammography screening and breast cancer diagnosis , but recommendations may apply in context s in which organized screening programs are not in place .
Women generally consider these undesirable effects acceptable ( low certainty of evidence ) , and a systematic review suggested that women place a relatively low value on the psychosocial and physical effects of false-positive results and overdiagnosis ; however , some studies raised concerns about whether women fully underst and the result ing implication s ( 15 ) .
How Often Should Women Attend an Organized Mammography Screening Program ?