Breast Cancer Screening and Diagnosis
Authors: Hans-Olov Adami, Philippe Autier
Journal: Annals of Internal Medicine (2020)

Letters16 June 2020Breast Cancer Screening and DiagnosisHans-Olov Adami, MD, PhD and Philippe Autier, MD, PhDHans-Olov Adami, MD, PhDKarolinska Institutet, Stockholm, Sweden (H.A.)Search for more papers by this author and Philippe Autier, MD, PhDUniversity of Strathclyde Institute of Global Public Health, International Prevention Research Institute, Lyon, France (P.A.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0252 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We found the ECIBC's updated guideline (1) concerning. Almost 50 years of intense research on mammography screening has made the balance between potential benefit and overwhelmingly documented harm so uncertain that the whole approach deserves reconsideration (2). The authors characterize their approach as “rigorous”; however, it is based on such selective, uncritical review of partly obsolete evidence that their recommendations, if implemented, may cause considerable harm and drain straitened health care resources.Contrary to a recent exhaustive review of mammography screening commissioned by the European Academy of Cancer Sciences (3), the ECIBC's guideline relies almost exclusively on ...References1. Schünemann HJ, Lerda D, Quinn C, et al; European Commission Initiative on Breast Cancer (ECIBC) Contributor Group. Breast cancer screening and diagnosis: a synopsis of the European Breast Guidelines. Ann Intern Med. 2020;172:46-56. [PMID: 31766052]. doi:10.7326/M19-2125 LinkGoogle Scholar2. Adami HO, Kalager M, Valdimarsdottir U, et al. Time to abandon early detection cancer screening [Editorial]. Eur J Clin Invest. 2019;49:e13062. [PMID: 30565674] doi:10.1111/eci.13062 CrossrefMedlineGoogle Scholar3. Autier P, Boniol M. Mammography screening: a major issue in medicine. Eur J Cancer. 2018;90:34-62. [PMID: 29272783] doi:10.1016/j.ejca.2017.11.002 CrossrefMedlineGoogle Scholar4. Kalager M, Zelen M, Langmark F, et al. Effect of screening mammography on breast-cancer mortality in Norway. N Engl J Med. 2010;363:1203-1210. [PMID: 20860502] doi:10.1056/NEJMoa1000727 CrossrefMedlineGoogle Scholar5. Kalager M, Bretthauer M. Improving cancer screening programs. Science. 2020;367:143-144. [PMID: 31919207] doi:10.1126/science.aay3156 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Karolinska Institutet, Stockholm, Sweden (H.A.)University of Strathclyde Institute of Global Public Health, International Prevention Research Institute, Lyon, France (P.A.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0252. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBreast Cancer Screening and Diagnosis: A Synopsis of the European Breast Guidelines Holger J. Schünemann , Donata Lerda , Cecily Quinn , Markus Follmann , Pablo Alonso-Coello , Paolo Giorgi Rossi , Annette Lebeau , Lennarth Nyström , Mireille Broeders , Lydia Ioannidou-Mouzaka , Stephen W. Duffy , Bettina Borisch , Patricia Fitzpatrick , Solveig Hofvind , Xavier Castells , Livia Giordano , Carlos Canelo-Aybar , Sue Warman , Robert Mansel , Francesco Sardanelli , Elena Parmelli , Axel Gräwingholt , Zuleika Saz-Parkinson , and Breast Cancer Screening and Diagnosis Karsten J. Jørgensen and Asger S. Paludan-Müller Breast Cancer Screening and Diagnosis Zuleika Saz-Parkinson , Stephen W. Duffy , Carlos Canelo-Aybar , Axel Gräwingholt , Cecily Quinn , Markus Follmann , and Holger J. Schünemann Metrics 16 June 2020Volume 172, Issue 12Page: 839-840KeywordsBreast cancerCancer screeningCancer treatmentConflicts of interestDisclosureHealth careMammographyMortalityPopulation statisticsRandomized trials ePublished: 16 June 2020 Issue Published: 16 June 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...