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Probability model estimates proportion of women who survive breast cancer detected through screening
Date:10/24/2011

during the same period is 1,910 per 100,000. The woman's observed 20-year probability of breast cancer death is 990 per 100,000. Assuming that screening mammography has already reduced risk of breast cancer death by 20 percent, the risk of death in the absence of screening would be 1,240 per 100,000, suggesting that the estimated benefit of screening amounted to 250 per 100,000. Therefore, the authors estimate that the probability that a woman with screen-detected breast cancer avoids breast cancer death because of mammography is 13 percent (250/1910).

The probability of the same 50-year-old woman avoiding breast cancer death increases to 17 percent if screening mammography reduces breast cancer mortality by 25 percent; however, probability decreases to 3 percent if screening mammography reduces breast cancer mortality by 5 percent. Similar analyses conducted for women of varying ages all yield probability estimates below 25 percent.

"We considered a range of values: namely, that screening mammography reduces breast cancer mortality anywhere from 5 percent to 25 percent. The values toward the high end (20 to 25 percent) reflect the randomized trial data from more than a quarter century ago," the authors conclude. "Consequently, we believe that readers should focus on the values toward the low end (5 to 10 percent) and recognize that the probability that a woman with screen-detected breast cancer has, in fact, avoided a breast cancer death because of screening mammography is now likely to be well below 10 percent."

(Arch Intern Med. Published online October 24, 2011. doi:10.1001/archinternmed.2011.476. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Invited Commentary: Screening. Simple Messages
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Contact: Deborah Kimbell
deborah.g.kimbell@dartmouth.edu
603-650-6694
JAMA and Archives Journals
Source:Eurekalert

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