Harms and benefits of mammographic screening for breast cancer in Brazil

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dc.contributor.authorMigowski, Arn
dc.contributor.authorNadanovsky, Paulo
dc.contributor.authorVianna, Cid Manso de Mello
dc.date.accessioned2025-01-31T13:44:56Z
dc.date.available2025-01-31T13:44:56Z
dc.date.issued2024
dc.description.abstractIntroduction In the absence of evidence on the effect of mammographic screening on overall mortality, comparing the number of deaths avoided with the number of deaths caused by screening would be ideal, but the only existing models of this type adopt a very narrow definition of harms. The objective of the present study was to estimate the number of deaths prevented and induced by various mammography screening protocols in Brazil. Methods A simulation study of cohorts of Brazilian women screened, considering various age groups and screening interval protocols, was performed based on life tables. The number of deaths avoided and caused by screening was estimated, as was the absolute risk reduction, the number needed to invite for screening—NNS, the net benefit of screening, and the ratio of “lives saved” to “lives lost”. Nine possible combinations of balances between benefits and harms were performed for each protocol, in addition to other sensitivity analyses. Results and conclusions The most efficient protocol was biennial screening from 60 to 69 years of age, with almost three times more deaths avoided than biennial screening from 50 to 59 years of age, with a similar number of deaths avoided by biennial screening from 50 to 69 years of age and with the greatest net benefit. Compared with the best scenario of annual screening from 40 to 49 years of age, the NNS of the protocol with biennial screening from 60 to 69 years of age was three-fold lower. Even in its best scenario, the addition of annual screening from 40 to 49 years of age to biennial screening from 50 to 69 years of age results in a decreased net ben- efit. However, even in the 50–69 year age group, the estimated reduction in breast cancer mortality for Brazil was half that estimated for the United Kingdom.
dc.identifier.citationMigowski A, Nadanovsky P, Manso de Mello Vianna C. Harms and benefits of mammographic screening for breast cancer in Brazil. PLoS One. 2024 Jan 25;19(1):e0297048. doi: 10.1371/journal.pone.0297048.
dc.identifier.otherDOI: 10.1371/journal.pone.0297048
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/775
dc.language.isoen
dc.publisherPLOS ONE
dc.subjectAgeden
dc.subjectBrazil / epidemiologyen
dc.subjectBreasten
dc.subjectBreast Neoplasms* / diagnostic imagingen
dc.subjectEarly Detection of Cancer / adverse effectsen
dc.subjectEarly Detection of Cancer / methodsen
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectMammography / adverse effectsen
dc.subjectMammography / methodsen
dc.subjectMass Screening / methodsen
dc.subjectMiddle Aged.en
dc.titleHarms and benefits of mammographic screening for breast cancer in Brazil
dc.typeArticle
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