title: European breast cancer service screening outcomes: a first balance sheet of the benefits and harms.
abstract: A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast cancer overdiagnosis, and false-positive results. On the basis of the studies reviewed, the authors present a first estimate of the benefit and harm balance sheet. For every 1,000 women screened biennially from ages 50 to 51 years until ages 68 to 69 years and followed up until age 79 years, an estimated seven to nine breast cancer deaths are avoided, four cases are overdiagnosed, 170 women have at least one recall followed by noninvasive assessment with a negative result, and 30 women have at least one recall followed by invasive procedures yielding a negative result. The chance of a breast cancer death being avoided by population-based mammography screening of appropriate quality is more than that of overdiagnosis by screening. These outcomes should be communicated to women offered service screening in Europe.
authors.affiliation: Authors' Affiliations: ISPO Cancer Prevention and Research Institute, Florence, Italy; e.paci@ispo.toscana.it.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Paci
authors.affiliation: Radboud University Nijmegen Medical Centre and National Expert and Training Centre for Breast Cancer Screening, Nijmegen, the Netherlands;
authors.forename: Mireille
authors.initials: M
authors.lastname: Broeders
authors.affiliation: Cancer Registry of Norway, Research Department and Oslo and Akershus University College of Applied Science, Oslo, Norway; and.
authors.forename: Solveig
authors.initials: S
authors.lastname: Hofvind
authors.affiliation: Authors' Affiliations: ISPO Cancer Prevention and Research Institute, Florence, Italy;
authors.forename: Donella
authors.initials: D
authors.lastname: Puliti
authors.affiliation: Wolfson Institute of Preventive Medicine, Queen Mary University, London, United Kingdom.
authors.forename: Stephen William
authors.initials: SW
authors.lastname: Duffy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D055088:Early Detection of Cancer / Q000401:mortality*; D005060:Europe; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D018570:Risk Assessment