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“Mammographic Screening Interval” by O’Meara et al. Report


Introduction and background

The study authors argue that previous studies show that mammography screening every two years for females is more beneficial than annual screening (O’Meara et al. 2013). In fact, it is argued that annual screening could be exemplified by negative impacts such as unwanted biopsies and more chances of over-diagnosis (Berg et al. 2012; Smith et al. 2011). Due to the two demerits of the annual breast examination, it is recommended that women aged 50 to 74 years should access biennial mammographic testing. However, women aged 40 to 49 years are not advised to undergo routine screening because there is inadequate evidence with regard to the early diagnosis of various conditions that could affect breasts (Chubak et al. 2010).

Over the years, age and race aspects have been considered with regard to breast cancer (Miglioretti 2013). Breast screening that would consider the race and age of a woman would be more useful in reducing adverse outcomes than testing that would be based only on age. With regard to breast cancer, it has been shown that Hispanic and black women have more chances of presenting with tumor features than their Asian and non-Hispanic counterparts (Siegel, Naishadham & Jemal 2013).

Thus, it would be prudent to conclude that Hispanic and black females would achieve more benefits from frequent breast screening. Due to the high mortality rates that are associated with black women suffering from breast cancer, it would be important for females in their 40s to undergo frequent testing (Smith et al. 2010). The study adopted a cohort approach to examine women populations living in the US. The purpose of the study was to “estimate the risks of unpleasant growth features that would be correlated with the biennial, annual and triennial screening mammography on the platforms of race/ethnicity and age groups” (O’Meara et al. 2013, p. 3960).

Methods

Mammography information in the form of data collected by the Breast Cancer Surveillance Consortium was compared with databases that contained pathology and tumor information. The study authors focused on the identification of females aged 40 to 74 years. The women were established to have undergone the three forms of screening between 1994 and 2008. The authors analyzed 14,396 cases of breast cancer, and they focused on establishing the negative impacts of false-positives within a 10-year period. In addition, risks were evaluated with regard to biopsy recommendations that were offered to 1,276,312 non-cases. Logistic regression analysis was utilized to approximate odds ratios (OR). A 95% confidence interval was adopted (O’Meara et al. 2013).

Results

The study established that no significant negative tumor features were correlated with screening annually and once every two years in white, black, and Hispanic females who were aged 40 to 49 years. In addition, on the platform of the two strategies of testing, Asian females aged 50 to 74 years did not exhibit adverse tumor features. There was a significant link between biennial testing and the chances of developing tumor characteristics in Hispanic women aged 50 to 74 years.

Triennial screening in all races of the women used in the study did not show significant chances of leading to adverse tumor features. Finally, the authors found that accumulated negative false-positive impacts significantly decreased with the length of screening intervals (O’Meara et al. 2013).

Discussion

The authors concluded that relatively long screening intervals were associated with higher chances of developing worse tumor features. In this context, annual screening was utilized as a reference (O’Meara et al. 2013). Furthermore, it was important to conclude that lower cumulative false-positive negative impacts were associated with long testing intervals. However, Hispanic women aged 50 to 74 years, and Asian females aged 40 to 49 years would be encouraged to undergo more frequent breast screening.

References

Berg, WA, Zhang, Z, Lehrer, D, Jong, RA, Pisano, ED, Barr, RG, Bohm-Velez, M, Mahoney, MC, Evans, WP, Larsen, LH, Morton, MJ, Mendelson, EB, Farria, DM, Cormack, JB, Marques, HS, Adams, A, Yeh, NM, Gabriel, G, & ACRIN 6666 Investigators, 2012, ‘Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk’, Jama, vol. 307, no. 13, pp. 1394-1404.

Chubak, J, Boudreau, DM, Fishman, PA, & Elmore, JG, 2010, ‘Cost of breast-related care in the year following false positive screening mammograms’, Medical care, vol. 48, no. 9, p. 815.

O’Meara, ES, Zhu, W, Hubbard, RA, Braithwaite, D, Kerlikowske, K, Dittus, KL, Geller, B, Wernli, KJ, & Miglioretti, DL, 2013, ‘Mammographic screening interval in relation to tumor characteristics and false‐positive risk by race/ethnicity and age’, Cancer, vol. 119, no. 22, pp. 3959-3967.

Siegel, R, Naishadham, D, & Jemal, A, 2013, ‘Cancer statistics, 2013’, CA: a cancer journal for clinicians, vol. 63, no. 1, pp. 11-30.

Smith, RA, Cokkinides, V, Brooks, D, Saslow, D, & Brawley, OW, 2010, ‘Cancer screening in the United States, 2010: a review of current American Cancer Society guidelines and issues in cancer screening’, CA: a cancer journal for clinicians, vol. 60, no. 2, pp. 99-119.

Smith, R. A., Cokkinides, V., Brooks, D., Saslow, D., Shah, M., & Brawley, O. W. (2011). Cancer screening in the United States, 2011. CA: A Cancer Journal for Clinicians, 61(1), 8-30.

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