[Assessment of usefulness and risk of mammography screening with exclusive attention to radiation risk].
In Germany, a vivid debate is still going on concerning the implantation of preventive mammographic screening into the national health care system. Before launching such a programme, benefits and risks have to be carefully assessed. The risk of radiation induced breast cancer was calculated in terms of mortality per 100.000 women using the risk estimates of BEIR. The radiation dose was assumed to be 8 mSv per examination (2 mGy per view, 2 views; RBE = 2, to be on the safe side). From the current literature regarding the benefits of screening, the number of deaths avoided per 100.000 women was estimated. Under the assumptions made in the model, screening from age 40 to 50 (six examinations at 2 years intervals, discontinuing at later age) might be associated with a benefit/risk ratio of about 6, whereas for women in the age group from 50 to 60 years the benefit/risk ratio was shown to be about 25. For a screening programme starting at the age of 50, the radiation risk involved does not appear to be a crucial issue. For performing mass screening with mammography beginning at the age of 40, radiation risks might have to be considered among a number of other risks associated with this age group.
Jung
H
H
Institut für Biophysik und Strahlenbiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg. biophys@uke.uni-hamburg.de
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000528:radiation effects*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality; D002423:Cause of Death; D005260:Female; D006801:Humans; D008327:Mammography / Q000295:instrumentation*; D008403:Mass Screening / Q000295:instrumentation*; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000401:mortality; D011829:Radiation Dosage; D018570:Risk Assessment; D016019:Survival Analysis