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 ?
Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancer in the Japan Strategic Anti-cancer Randomized Trial (J-START): a randomised controlled trial
BACKGROUND Mammography is the only proven method for breast cancer screening that reduces mortality , although it is inaccurate in young women or women with dense breasts . We investigated the efficacy of adjunctive ultrasonography . METHODS Between July , 2007 , and March , 2011 , we enrolled asymptomatic women aged 40 - 49 years at 42 study sites in 23 prefectures into the Japan Strategic Anti-cancer R and omized Trial ( J-START ) . Eligible women had no history of any cancer in the previous 5 years and were expected to live for more than 5 years . R and omisation was done central ly by the Japan Clinical Research Support Unit . Participants were r and omly assigned in 1:1 ratio to undergo mammography and ultrasonography ( intervention group ) or mammography alone ( control group ) twice in 2 years . The primary outcome was sensitivity , specificity , cancer detection rate , and stage distribution at the first round of screening . Analysis was by intention to treat . This study is registered , number UMIN000000757 . FINDINGS Of 72,998 women enrolled , 36,859 were assigned to the intervention group and 36,139 to the control group . Sensitivity was significantly higher in the intervention group than in the control group ( 91·1 % , 95 % CI 87·2 - 95·0 vs 77·0 % , 70·3 - 83·7 ; p=0·0004 ) , whereas specificity was significantly lower ( 87·7 % , 87·3 - 88·0 vs 91·4 % , 91·1 - 91·7 ; p<0·0001 ) . More cancers were detected in the intervention group than in the control group ( 184 [ 0·50 % ] vs 117 [ 0·32 % ] , p=0·0003 ) and were more frequently stage 0 and I ( 144 [ 71·3 % ] vs 79 [ 52·0 % ] , p=0·0194 ) . 18 ( 0·05 % ) interval cancers were detected in the intervention group compared with 35 ( 0·10 % ) in the control group ( p=0·034 ) . INTERPRETATION Adjunctive ultrasonography  increases sensitivity and detection rate of early cancers . FUNDING Ministry of Health , Labour and Welfare of Japan
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 ?