A limited review of over diagnosis methods and long-term effects in breast cancer screening

• Main Authors: Dongfeng Wu, Adriana Pérez
• Format: Article
• Language: English
• Published: PAGEPress Publications 2011-09-01
• Series: Oncology Reviews
• Subjects: True early detection - No early detection - Long-term effect - Probability modeling
• Online Access: http://www.oncologyreviews.org/index.php/or/article/view/11

Breast cancer screening programs have been effective in detecting tumors prior to symptoms. Recently, there has been concern over the issue of over-diagnosis, that is, diagnosis of a breast cancer that does not manifest prior to death. Estimates for over-diagnosis vary, ranging from 7 to 52%. This variability may be due partially to issues associated with bias and/or incorrect inferences associated with the lack of probability modeling. A critical issue is how to evaluate the long-term effects due to continued screening. Participants in a periodic screening program can be classified into four mutually exclusive groups depending on whether individuals are diagnosed and whether their symptoms appear prior to death: True-earlydetection; No-early-detection; Over-diagnosis; and Not-sonecessary. All initially superficially healthy people will eventually fall into one of these four categories. This manuscript reviews the major methodologies associated with the over-diagnosis and long-term effects of breast cancer screening.