Review of Mammographic Screening Trials in Western Countries: Mortality Reduction in Women Younger than 49.:Mortality Reduction in Women Younger than 49

概要

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Randomized control trials (RCTs) and case control studies of mammographic screening have shown mortality reductions in women aged 50 and over with breast cancer in western countries. However, the effectiveness of mammographic screening for women younger than 49 is still controversial. We have reviewed the articles describing the relative risks obtained in clinical trials involving women younger than 49. Seven RCTs, but not Canada NBSS 1, demonstrated mortality reduction of 18%, but 4 case control studies showed no reduction in deaths due to breast cancer, suggesting that the statistical power of mammographic screening is not as high for women younger than 49 as it is for those over 50. Recent data based on excess mortality rates, however, showed a mortality reduction of 23% in women aged 40-49 screened in northern Sweden.<BR>In order to establish quality control criteria for mammographic breast cancer screening, which is not conducted routinely yet, the study group "Quality control of breast cancer screening with mammography" was organized in Japan. The essential issues, including cost-effectiveness in comparison with clinical breast examination, have been analyzed. The critical issues, including sensitivity and risk-effectiveness analysis, should be evaluated before mammographic screening for younger women is adopted routinely.
日本乳癌検診学会の論文