Rethinking screening for breast cancer and prostate cancer.
After 20 years of screening for breast and prostate cancer, several observations can be made. First, the incidence of these cancers increased after the introduction of screening but has never returned to prescreening levels. Second, the increase in the relative fraction of early stage cancers has increased. Third, the incidence of regional cancers has not decreased at a commensurate rate. One possible explanation is that screening may be increasing the burden of low-risk cancers without significantly reducing the burden of more aggressively growing cancers and therefore not resulting in the anticipated reduction in cancer mortality. To reduce morbidity and mortality from prostate cancer and breast cancer, new approaches for screening, early detection, and prevention for both diseases should be considered.
Department of Surgery and Radiology, University of California, San Francisco, San Francisco, CA 94115, USA. laura.esserman@ucsfmedctr.org
Laura
L
Esserman
Yiwey
Y
Shieh
Ian
I
Thompson
D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D017281:Cost of Illness; D055088:Early Detection of Cancer; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008327:Mammography; D008403:Mass Screening / Q000639:trends; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D018570:Risk Assessment; D014481:United States
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen