Our review was begun early in 2000. A first draft was presented to the USPSTF in December 2000. Throughout 2001, the manuscript underwent extensive critical review by a broad range of experts. Subsequent versions were reviewed by the USPSTF in September 2001 and in January 2002.
The authors thank Stephanie Detlefsen, M.D., for her contribution to this evidence review and David Atkins, M.D., M.P.H., from AHRQ, and USPSTF members for their comments on earlier versions of the review. We also thank Kathryn Pyle Krages, A.M.L.S., M.A., Susan Carson, M.P.H., Patty Davies, M.S., Susan Wingenfeld, and Jim Wallace for their help with preparation of the manuscript and the full systematic evidence review.
From: Oregon Health & Science University and Portland Veterans Affairs Medical Center, Portland, OR; and Medical College of Virginia, Virginia Commonwealth University, Fairfax, VA.
Note: This manuscript is based on a longer Systematic Evidence Review that was reviewed by outside experts and representatives of professional societies.
Disclaimer: The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Grant Support: This study was conducted by the Oregon Health & Science University Evidence-based Practice Center under contract to AHRQ (contract No. 290-97-0018, task order No. 2), Rockville, MD.
1. American Cancer Society. Cancer Facts and Figures, 2001. Available at: http://www.cancer.org/downloads/STT/F&F2001.pdf.
2. Gail M, Brinton, LA, Byar, DP, et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 1989;81:1879-86.
3. Colditz GA, Willett WC, Hunter DJ, et al. Family history, age, and risk of breast cancer. Prospective data from the Nurses' Health Study [published erratum appears in JAMA 1993;270(13):1548]. JAMA 1993;270(3):338-43.
4. Seidman H, Stellman SD, Mushinski MH. A different perspective on breast cancer risk factors: some implications of the nonattributable risk. Cancer 1982;32:301-12.
5. Strax P. Mass screening of asymptomatic women. In: Ariel IM, Cleary J, eds. Breast Cancer: Diagnosis and Treatment. New York: McGraw-Hill; 1987:145-51.
6. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd ed. Baltimore: Williams & Wilkins; 1996.
7. Sirovich BE, Sox HC Jr. Breast cancer screening. Surg Clin North Am 1999;79(5):961-90.
8. Olsen O, Gotzsche PC. Cochrane review on screening for breast cancer with mammography. Lancet 2001;358(9290):1340-2.
9. Harris RP, Helfand M, Woolf SH, et al. Methods of the third U.S. Preventive Services Task Force. Am J Prev Med 2001;20(suppl 3):21-35.
10. Harrison TR. Breast cancer. In: Fauci AS, ed. Principles of Internal Medicine. 14th ed. New York: McGraw Hill; 1998:564-7.
11. WinBUGS Version 1.2 User Manual. Cambridge, England: MRC Biostatistics Unit; 1999.
12. Miller AB, Baines CJ, To T, Wall C. Canadian National Breast Screening Study: 1. Breast cancer detection and death rates among women aged 40 to 49 years [published erratum appears in CMAJ 1993;148(5):718]. CMAJ 1992;147:1459-76.
13. Miller AB, Baines CJ, To T, Wall C. Canadian National Breast Screening Study: 2. Breast cancer detection and death rates among women aged 50 to 59 years [published erratum appears in CMAJ 1993;148(5):718]. CMAJ 1992;147:1477-88.
14. Bjurstam N, Bjorneld L, Duffy SW, et al. The Gothenburg Breast Cancer Screening Trial: preliminary results on breast cancer mortality for women aged 39-49 [letter]. J Natl Cancer Inst Monogr 1997;22:53-5.
15. Andersson I, Janzon L. Reduced breast cancer mortality in women under age 50: updated results from the Malmö Mammographic Screening Program. J Natl Cancer Inst Monogr 1997;22:63-7.
16. Tabar L, Fagerberg G, Chen HH, et al. Efficacy of breast cancer screening by age: new results from the Swedish Two-County Trial. Cancer 1995;75:2507-17.
17. Frisell J, Lidbrink E, Hellstrom L, Rutqvist LE. Followup after 11 years: update of mortality results in the Stockholm mammographic screening trial. Breast Cancer Res Treat 1997;45:263-70.
18. Alexander FE, Anderson TJ, Brown HK, et al. 14 years of followup from the Edinburgh randomised trial of breast-cancer screening. Lancet 1999;353(9168):1903-8.
19. Shapiro S, Venet W, Strax P, Venet L. Current results of the breast cancer screening randomized trial: the Health Insurance Plan (HIP) of greater New York study. In: Day NE, Miller AB, eds. Screening for Breast Cancer. Toronto: Hans Huber; 1988:3-15.
20. Miller AB, To T, Baines CJ, Wall C. The Canadian National Breast Screening Study-2: 13-year results of a randomized trial in women aged 50-59 years. J Natl Cancer Inst 2000;92(18):1490-9.
21. Miller AB, To T, Baines CJ, Wall C. The Canadian National Breast Screening Study: update on breast cancer mortality. J Natl Cancer Inst Monogr 1997;22:37-41.
22. Miller AB, To T, Baines CJ, Wall C. The Canadian National Breast Screening Study - I, breast cancer mortality after 11-16 years of followup in women age 40-49. Ann Intern Med 2002;137:305-12.
23. Nystrom L, Andersson I, Bjurstam N, Frisell J, Nordenskjold B, Rutqvist LE. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet 2002;359:909-19.
24. Bjurstam N, Bjorneld L, Duffy SW, et al. The Gothenburg breast screening trial: first results on mortality, incidence, and mode of detection for women ages 39-49 years at randomization. Cancer 1997;80(11):2091-9.
25. Andersson I, Aspegren K, Janzon L, et al. Mammographic screening and mortality from breast cancer: the Malmö mammographic screening trial. BMJ 1988;297:943-8.
26. Tabar L, Vitak B, Chen HH, et al. The Swedish Two-County Trial twenty years later: updated mortality results and new insights from long-term followup. Radiol Clin North Am 2000;38(4):625-51.
27. Shapiro S. Periodic screening for breast cancer: the HIP Randomized Controlled Trial. Health Insurance Plan. J Natl Cancer Inst Monogr 1997;22:27-30.
28. Tabar L, Fagerberg G, Duffy SW, Day NE. The Swedish two county trial of mammographic screening for breast cancer: recent results and calculation of benefit. J Epidemiol Community Health 1989;43:107-14.
29. Black WC, Haggstrom DA, Welch HG. All-cause mortality in randomized trials of cancer screening. J Natl Cancer Inst 2002;94(3):167-73.
30. Berry DA. Benefits and risks of screening mammography for women in their forties: a statistical appraisal. J Natl Cancer Inst 1998;90(19):1431-9.
31. Sjonell G, Stahle L. Halsokontroller med mammografi minskar inte dodlighet i brostcancer. [Mammographic screening does not reduce breast cancer mortality]. Lakartidningen 1999;96:904-905; 908-13.
32. Nystrom L, Rutqvist LE, Wall S, et al. Breast cancer screening with mammography: overview of Swedish randomised trials [published erratum appears in Lancet 1993;342(8883):1372]. Lancet 1993;341(8851):973-8.
33. Nystrom L, Larsson LG, Wall S, et al. An overview of the Swedish randomised mammography trials: total mortality pattern and the representivity of the study cohorts. J Med Screen 1996;3:85-7.
34. Tabar L, Gad A, Holmberg L, Ljungquist U. Significant reduction in advanced breast cancer.: results of the first seven years of mammography screening in Kopparberg, Sweden. Diagn Imaging Clin Med 1985;54:158-64.
35. Tabar L, Fagerberg CJ, Gad A, et al. Reduction in mortality from breast cancer after mass screening with mammography: randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet 1985;1.
36. Mushlin AI, Kouides RW, Shapiro DE. Estimating the accuracy of screening mammography: a meta-analysis. Am J Prev Med 1998;14(2):143-53.
37. Shen Y, Zelen M. Screening sensitivity and sojourn time from breast cancer early detection clinical trials: mammograms and physical examinations. J Clin Oncol 2001;19(15):3490-9.
38. Laya MB, Larson EB, Taplin SH, White E. Effect of estrogen replacement therapy on the specificity and sensitivity of screening mammography. J Natl Cancer Inst 1996;88(10):643-9.
39. Greendale GA, Reboussin BA, Sie A, et al. Effects of estrogen and estrogen-progestin on mammographic parenchymal density. Postmenopausal Estrogen/Progestin Interventions (PEPI) Investigators. Ann Intern Med 1999;130:262-9.
40. Marugg RC, van der Mooren MJ, Hendriks JH, Rolland R, Ruijs SH. Mammographic changes in postmenopausal women on hormonal replacement therapy. Eur Radiol 1997;7(5):749-55.
41. Kerlikowske K, Grady D, Barclay J, Sickles EA, Ernster V. Effect of age, breast density, and family history on the sensitivity of first screening mammography. JAMA 1996;276(1):33-8.
42. Kerlikowske K, Grady D, Barclay J, Sickles EA, Ernster V. Likelihood ratios for modern screening mammography: risk of breast cancer based on age and mammographic interpretation. JAMA 1996;276:39-43.
43. Eddy D. Screening for breast cancer. Ann Intern Med 1989;111:389-99.
44. Lidbrink E, Elfving J, Frisell J, Jonsson E. Neglected aspects of false positive findings of mammography in breast cancer screening: analysis of false positive cases from the Stockholm trial. BMJ 1996;312(7026):273-6.
45. Fletcher S, Black W, Harris R, Rimer BK, Shapiro S. Report of the International Workshop on Screening for Breast Cancer. J Natl Cancer Inst 1993;85:1644-56.
46. Humphrey L, Helfand M. Screening for Breast Cancer. Systematic Evidence Review No. 15 (Prepared by the Oregon Health & Science University Evidence-based Practice Center under Contract No. 290-97-0018). Rockville, MD: Agency for Healthcare Research and Quality. September 2002. (Available at http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat3.chapter.27509).
47. Kerlikowske K, Grady D, Barclay J, Sickles EA, Eaton A, Ernster V. Positive predictive value of screening mammography by age and family history of breast cancer. JAMA 1993;270(20):2444-50.
48. Glasziou PP, Woodward AJ, Mahon CM. Mammographic screening trials for women aged under 50: a quality assessment and meta-analysis. Med J Aust 1995;162(12):625-9.
49. Miller AB, Baines CJ, To T, Wall C. Screening mammography re-evaluated [letter]. Lancet 2000;355(9205):747.
50. Larsson LG, Andersson I, Bjurstam N, et al. Updated overview of the Swedish Randomized Trials on Breast Cancer Screening with Mammography: age group 40-49 at randomization. J Natl Cancer Inst Monogr 1997:57-61.
51. Cox B. Variation in the effectiveness of breast screening by year of followup. J Natl Cancer Inst Monogr 1997(22):69-72.
52. Elwood JM, Cox B, Richardson AK. The effectiveness of breast cancer screening by mammography in younger women. Online J Curr Clin Trials [serial online] 1993;doc 32.
53. Glasziou P, Irwig L. The quality and interpretation of mammographic screening trials for women ages 40-49. J Natl Cancer Inst Monogr 1997(22):73-7.
54. Glasziou PP. Meta-analysis adjusting for compliance: the example of screening for breast cancer. J Clin Epidemiol 1992;45(11):1251-6.
55. Hendrick RE, Smith RA, Rutledge JH III, Smart CR. Benefit of screening mammography in women aged 40-49: a new meta-analysis of randomized controlled trials. J Natl Cancer Inst Monogr 1997(22):87-92.
56. Smart CR, Hendrick RE, Rutledge JH III, Smith RA. Benefit of mammography screening in women ages 40 to 49 years: current evidence from randomized controlled trials [published erratum appears in Cancer 1995;75(11)]. Cancer 1995;75(7):1619-26.
57. Kerlikowske K, Grady D, Ernster V. Benefit of mammography screening in women ages 40-49 years: current evidence from randomized controlled trials [letter]. Cancer 1995;76(9):1679-81.
58. Kerlikowske K. Efficacy of screening mammography among women aged 40 to 49 years and 50 to 69 years: comparison of relative and absolute benefit. J Natl Cancer Inst Monogr 1997(22):79-86.
59. Tabar L, Fagerberg G, Chen HH, Duffy SW, Gad A. Screening for breast cancer in women aged under 50: mode of detection, incidence, fatality, and histology. J Med Screen 1995;2:94-8.
60. Larsson LG, Nystrom L, Wall S, et al. The Swedish randomised mammography screening trials: analysis of their effect on the breast cancer related excess mortality. J Med Screen 1996;3(3):129-32.
61. Barton MB, Harris R, Fletcher SW. Does this patient have breast cancer? The screening clinical breast examination: should it be done? How? JAMA 1999;282(13):1270-80.
62. Elmore JG, Barton MB, Moceri VM, Polk S, Arena PJ, Fletcher SW. Ten-year risk of false positive screening mammograms and clinical breast examinations. N Engl J Med 1998;338(16):1089-96.
63. Shapiro S. Evidence on screening for breast cancer from a randomized trial. Cancer (Philadelphia) 1977;39:2772-82.
64. Anonymous. 16-year mortality from breast cancer in the UK Trial of Early Detection of Breast Cancer. Lancet 1999;353(9168):1909-14.
65. Baines CJ. The Canadian National Breast Screening Study: responses to controversy. Womens Health Issues 1992;2(4):206-11.
66. Richert-Boe KE, Humphrey LL. Screening for cancers of the cervix and breast. Arch Intern Med 1992;152(12):2405-11.
67. Semiglazov VF, Moiseyenko VM, Bavli JL, et al. The role of breast self-examination in early breast cancer detection (results of the 5-years USSR/WHO randomized study in Leningrad). Eur J Epidemiol 1992;8(4):498-502.
68. Semiglazov VF, Moiseenko VM, Manikhas AG, et al. [Interim results of a prospective randomized study of self-examination for early detection of breast cancer (Russia/St.Petersburg/WHO)]. The role of breast self-examination in early breast cancer detection (results of the 5-years USSR/WHO randomized study in Leningrad). Vopr Onkol 1999;45(3):265-71.
69. Thomas DB, Gao DL, Self SG, et al. Randomized trial of breast self-examination in Shanghai: methodology and preliminary results. J Natl Cancer Inst 1997;89(5):355-65.
70. Pisano ED, Earp J, Schell M, Vokaty K, Denham A. Screening behavior of women after a false-positive mammogram. Radiology 1998;208(1):245-9.
71. Ekeberg O, Skjauff H, Karesen R. Screening for breast cancer is associated with a low degree of psychological distress. The Breast 2001;10(1):20-4.
72. Lampic C, Thurfjell E, Bergh J, Sjoden PO. Short- and long-term anxiety and depression in women recalled after breast cancer screening. Eur J Cancer 2001;37(4):463-9.
73. Meystre-Agustoni G, Pacccaud F, Jeannin A, Dubois-Arber F. Anxiety in a cohort of Swiss women participating in a mammographic screening programme. J Med Screen 2001;8(4):213-9.
74. Lerman C, Track B, Rimer BK, Boyce A, Jepson C, Engstrom PF. Psychological and behavioral implications of abnormal mammograms. Ann Int Med 1991;114:657-61.
75. Rimer BK, Bluman LG. The psychosocial consequences of mammography. J Natl Cancer Inst Monogr 1997(22):131-8.
76. Olsson P, Armelius K, Nordahl G, Lenner P, Westman G. Women with false positive screening mammograms: how do they cope? J Med Screen 1999;6:89-93.
77. O'Sullivan I, Sutton S, Dixon S, Perry N. False positive results do not have a negative effect on reattendance for subsequent breast screening. J Med Screen 2001;8:145-8.
78. Lipkus IM, Kuchibhatla M, McBride C, et al. Relationships among Breast Cancer Percieved Absolute Risk, Comparative Risk, and Worries. Cancer Epidemiol Biomarkers Prev 2000;9:973-5.
79. Burman ML, Taplin SH, Herta DF, Elmore JG. Effect of false-positive mammograms on interval breast cancer screening in a health maintenance organization. Ann Intern Med 1999;131(1):1-6.
80. Schwartz LM, Woloshin S, Sox HC, Fischhoff B, Welch HG. U.S. women's attitudes to false positive mammography results and detection of ductal carcinoma in situ: cross sectional survey. BMJ 2000;320(7250):1635-40.
81. Harstall C. Mammography Screening: Mortality Rate Reduction and Screening Interval. Edmonton: Alberta Heritage Foundation for Medical Research; 2000.
82. Ernster VL, Barclay J. Increases in ductal carcinoma in situ (DCIS) of the breast in relation to mammography: a dilemma. J Natl Cancer Inst Monogr 1997(22):151-6.
83. Mattsson A, Leitz W, Rutqvist LE. Radiation risk and mammographic screening of women from 40 to 49 years of age: effect on breast cancer rates and years of life. Br J Cancer 2000;82(1):220-6.
84. Feig SA, Hendrick RE. Radiation risk from screening mammography of women aged 40-49 years. J Natl Cancer Inst Monogr 1997(22):119-24.
85. Swift M, Morrell D, Massey RB, Chase CL. Incidence of cancer in 161 families affected by ataxia-telangiectasia. N Engl J Med 1991;325(26):1831-6.
86. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. Baltimore, MD: Williams and Wilkins; 1989.
87. Kerlikowske K, Grady D, Rubin SM, Sandrock C, Ernster VL. Efficacy of screening mammography: a meta-analysis. JAMA 1995;273(2):149-54.
88. Fletcher SW. Why question screening mammography for women in their forties? Radiol Clin North Am 1995;33(6):1259-71.
89. Tabar L, Duffy SW, Chen HH. Re: Quantitative interpretation of age-specific mortality reductions from the Swedish Breast Cancer-Screening Trials. J Natl Cancer Inst 1996;88(1):52-5.
90. McPherson K, Steel CM, Dixon JM. ABC of breast diseases: breast cancer-epidemiology, risk factors, and genetics. BMJ 2000;321(7261):624-8.
91. Ries LAG, Eisner MP, Kosary CL, et al. SEER Cancer Statistics Review, 1973-1997. Bethesda, MD: National Cancer Institute; 2000. NIH Pub. No. 00-2789.
92. Kopans DB. An overview of the breast cancer screening controversy. J Natl Cancer Inst Monogr 1997(22):1-3.
93. Satariano WA, Ragland DR. The effect of comorbidity on 3-year survival of women with primary breast cancer. Ann Intern Med 1994;120(2):104-10.
94. Kerlikowske K, Salzmann P, Phillips KA, Cauley JA, Cummings SR. Continuing screening mammography in women aged 70 to 79 years: impact on life expectancy and cost-effectiveness. JAMA 1999;282(22):2156-63.
95. Tabar L, Faberberg G, Day NE, Holmberg L. What is the optimum interval between mammographic screening examinations? An analysis based on the latest results of the Swedish two- county breast cancer screening trial. Br J Cancer 1987;55:547-51.
96. Duffy SW, Day NE, Tabar L, Chen HH, Smith TC. Markov models of breast tumor progression: some age-specific results. J Natl Cancer Inst Monogr 1997;22:93-7.
97. Duffy SW, Chen HH, Tabar L, Fagerberg G, Paci E. Sojourn time, sensitivity and positive predictive value of mammography screening for breast cancer in women aged 40-49. Int J Epidemiol 1996;25:1139-45.
98. Kramer BS, Brawley OW. Cancer screening. Hematol Oncol Clin North Am 2000;14(4):831-48.
99. Skrabanek P. False premises and false promises of breast cancer screening. Lancet 1985(August 10):316-20.
100. Ringash J. Canadian Task Force on Preventive Health Care. Preventive health care, 2001 update: screening mammography among women aged 40-49 years at average risk of breast cancer. CMAJ 2001;164(4):469-76.
101. Tabar L, Vitak B, Chen HHT, et al. Beyond randomized controlled trials: organized mammographic screening substantially reduces breast carcinoma mortality. Cancer 2001;91(9):1724-31.
102. Gotzsche PC, Olsen O. Is screening for breast cancer with mammography justifiable? Lancet 2000;355(9198):129-34.
103. Rajkumar SV, Hartmann LC. Screening mammography in women aged 40-49 years. Medicine 1999;78(6):410-6.
104. Moss S. A trial to study the effect on breast cancer mortality of annual mammographic screening in women starting at age 40. Trial Steering Group. J Med Screen 1999;6:144-8.
105. Ng EH, Ng FC, Tan PH, et al. Results of intermediate measures from a population-based, randomized trial of mammographic screening prevalence and detection of breast carcinoma among Asian women: the Singapore Breast Screening Project [published erratum appears in Cancer 1998;83(1):191]. Cancer 1998;82:1521-8.
106. Hakama MPEHM, Kallio M. Effectiveness of the public health policy for breast cancer screening in Finland: population based cohort study. BMJ 1997;314:864-7.
107. Hakama M, Pukkala E, Söderman B, et al. Implementation of screening as a public health policy: issues in design and evaluation. J Med Screen 1999;6:209-16.
108. Berglund G, Nilsson P, Eriksson KF, et al. Long-term outcome of the Malmö preventive project: mortality and cardiovascular morbidity. J Intern Med 2000;247(1):19-29.
109. Verbeek AL, Hendriks JH, Holland R, et al. Reduction of breast cancer mortality through mass screening with modern mammography: first results of the Nijmegen project, 1975-1981. Lancet 1984;1:1222-4.
110. Chamberlain J, Coleman D, Ellman R, et al. Verification of the cause of death in the trial of early detection of breast cancer: UK Trial of Early Detection of Breast Cancer Group. Trial Co-ordinating Centre. Br J Cancer 1991;64(6):1151-6.
111. Collette HJ, de Waard F, Rombach JJ, et al. Further evidence of benefits of a (non-randomised) breast cancer screening programme: the DOM project. J Epidemiol Community Health 1992;46(4):382-6.
112. Moher D, Pham B, Jones A, et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? [see comments.]. Lancet 1998;352(9128):609-13.
113. Schulz KF, Chalmers I, Hayes RJ, et al. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273(5):408-12.
114. Prorok PC, Hankey BF, Bundy BN. Concepts and problems in the evaluation of screening programs. J Chron Dis 1981;34:159-71.
115. Schulz KF, Grimes DA, Altman DG, et al. Blinding and exclusions after allocation in randomized controlled trials: survey of published parallel group trials in obstetrics and gynecology. BMJ 1996;312:742-4.
116. Johansen HK, Gotzsche PC. Problems in the design and reporting of trials of antifungal agents encountered during meta-analysis. JAMA 1999;282(18):1752-9.
117. Bailar JC. Mammography: a contrary view. Ann Intern Med 1976;84:77-84.
118. Skrabanek P. Mass mammography: the time for reappraisal. Int J Technol Assess Health Care 1989;5(3):423-30.
119. Schmidt JG. The epidemiology of mass breast cancer screening—a plea for a valid measure of benefit. J Clin Epidemiol 1990;43:215-25.
120. Tarone R. The excess of patients with advanced breast cancer in young women screened with mammography in the Canadian National Breast Screening Study. Cancer 1995;75:997-1003.
121. Sutton AJ, Abams KR, Jones DR, et al. Methods for Meta-analysis in Medical Research (Wiley Series in Probability and Statistics). Chichester: John Wiley and Sons, Ltd.; 2000.
122. Habbema JD, van Oortmarssen GJ, van Putten DJ, Lubbe JT, van der Maas PJ. Age-specific reduction in breast cancer mortality by screening an analysis of the results of the Health Insurance Plan of Greater New York study. J Natl Cancer Inst 1986;77:317-20.
123. Shapiro S, Venet W, Straz P, Venet L, Roeser R. Selection, followup, and analysis in the Health Insurance Plan Study: a randomized trial with breast cancer screening. Natl Cancer Inst Monogr 1985;67:65-74.
124. Frisell J, Lidbrink E. The Stockholm Mammographic Screening Trial: risks and benefits in age group 40-49 years. J Natl Cancer Inst Monogr 1997;22:49-51.
125. Frisell J, Eklund G, Hellstrom L, Lidbrink E, Rutqvist LE, Somell A. Randomized study of mammography screening: preliminary report on mortality in the Stockholm trial. Breast Cancer Res Treat 1991;18:49-56.
126. Alexander FE. The Edinburgh Randomized Trial of Breast Cancer Screening. J Natl Cancer Inst Monogr 1997;22:31-5.
127. Alexander FE, Anderson TJ, Brown HK. The Edinburgh randomised trial of breast cancer screening: results after 10 years of followup. Br J Cancer 1994;70:542-48.
128. Roberts MM, Alexander FE, Anderson TJ, et al. Edinburgh trial of screening for breast cancer: mortality at seven years. Lancet 1990;335:241-46.
a Dr. Humphrey, Dr. Helfand, and Mr. Chan: Oregon Health & Science University, Portland, OR.
b Dr. Woolf: Virginia Commonwealth University, Fairfax, VA.
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Source: Humphrey LL, Helfand M, Chan BKS, Woolf SH. Breast cancer screening: summary of the evidence. Ann Intern Med 2002;137:344-6.
Disclaimer: The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement in this article should be construed as an official position of the U.S. Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Internet Citation
Humphrey LL, Helfand M, Chan BKS, Woolf SH. Breast Cancer Screening: Summary of the Evidence. Originally in Ann Intern Med 2002;137:344-6.Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/3rduspstf/breastcancer/bcscrnsum1.htm
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