Overdiagnosis and overtreatment of breast cancer: overdiagnosis in randomised controlled trials of breast cancer screening.
Data from randomised controlled trials of mammographic screening can be used to determine the extent of any overdiagnosis, as soon as either a time equivalent to the lead-time has elapsed after the final screen, or the control arm has been offered screening. This paper reviews those randomised trials for which breast cancer incidence data are available. In recent trials in which the control group has not been offered screening, an excess incidence of breast cancer remains after many years of follow-up. In those trials in which the control arm has been offered screening, although there is a possible shift from invasive to in situ disease, there is no evidence of overdiagnosis as a result of incident screens.
Moss
Sue
S
Cancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK. sue.moss@icr.ac.uk
D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008327:Mammography / Q000592:standards*; D008403:Mass Screening / Q000379:methods; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D015203:Reproducibility of Results