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Скрининг на предмет рака молочной железы с помощью маммографии

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Referencias

References to studies included in this review

Ir a:

Canada 1980 {published and unpublished data}

Bailar JC, MacMahon B. Randomization in the Canadian National Breast Screening Study: a review for evidence of subversion. Canadian Medical Association Journal 1997;156(2):193‐9.
Baines CJ. Personal communication 18 Jan 2001.
Baines CJ. A different view on what is known about breast screening and the Canadian National Breast Screening Study. Cancer 1994;74(4):1207‐11.
Baines CJ. Impediments to recruitment in the Canadian National Breast Screening Study: response and resolution. Controlled Clinical Trials 1984;5(2):129‐40.
Baines CJ. NBSS: changes were made, suspicious changes were not [letter]. CMAJ 1997;157(3):248‐50.
Baines CJ. The Canadian National Breast Screening Study. Why? What next? And so what?. Cancer 1995;76 Suppl(10):2107‐12.
Baines CJ. The Canadian National Breast Screening Study: a perspective on criticisms. Annals of Internal Medicine 1994;120(4):326‐34.
Baines CJ. The Canadian National Breast Screening Study: responses to controversy. Womens Health Issues 1992;2(4):206‐11.
Baines CJ, Christen A, Simard A, Wall C, Dean D, Duncan L, et al. The National Breast Screening Study: pre‐recruitment sources of awareness in participants. Canadian Journal of Public Health 1989;80(3):221‐5.
Baines CJ, McFarlane DV, Miller AB. Sensitivity and specificity of first screen mammography in 15 NBSS centres. Canadian Association of Radiologists Journal 1988;39(4):273‐6.
Baines CJ, McFarlane DV, Miller AB. The role of the reference radiologist. Estimates of inter‐observer agreement and potential delay in cancer detection in the national breast screening study. Investigative Radiology 1990;25(9):971‐6.
Baines CJ, McFarlane DV, Wall C. Audit procedures in the National Breast Screening Study: mammography interpretation. Canadian Association of Radiologists Journal 1986;37(4):256‐60.
Baines CJ, Miller AB. Mammography versus clinical examination of the breasts. Journal of the National Cancer Institute. Monographs 1997;22:125‐9.
Baines CJ, Miller AB, Bassett AA. Physical examination. Its role as a single screening modality in the Canadian National Breast Screening Study. Cancer 1989;63(9):1816‐22.
Baines CJ, Miller AB, Kopans DB, Moskowitz M, Sanders DE, Sickles EA, et al. Canadian National Breast Screening Study: assessment of technical quality by external review. AJR. American Journal of Roentgenology 1990;155(4):743‐7.
Baines CJ, Miller AB, Wall C, McFarlane DV, Simor IS, Jong R, et al. Sensitivity and specificity of first screen mammography in the Canadian National Breast Screening Study: a preliminary report from five centers. Radiology 1986;160(2):295‐8.
Baines CJ, To T. Changes in breast self‐examination behavior achieved by 89,835 participants in the Canadian National Breast Screening Study. Cancer 1990;66(3):570‐6.
Baines CJ, To T, Wall C. Women's attitudes to screening after participation in the National Breast Screening Study. A questionnaire survey. Cancer 1990;65(7):1663‐9.
Baines CJ, Vidmar M, McKeown Eyssen G, Tibshirani R. Impact of menstrual phase on false‐negative mammograms in the Canadian National Breast Screening Study. Cancer 1997;80(4):720‐4.
Baines CJ, Wall C, Risch HA, Kuin JK, Fan IJ. Changes in breast self‐examination behavior in a cohort of 8214 women in the Canadian National Breast Screening Study. Cancer 1986;57(6):1209‐16.
Basinski AS. The Canadian National Breast Screening Study: opportunity for a rethink. CMAJ 1992;147(10):1431‐4.
Boyd NF. The review of randomization in the Canadian National Breast Screening Study. Is the debate over?. CMAJ 1997;156(2):207‐9.
Boyd NF, Byng JW, Jong RA, Fishell EK, Little LE, Miller AB, et al. Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. Journal of the National Cancer Institute 1995;87(9):670‐5.
Boyd NF, Jensen HM, Cooke G, Han HL. Relationship between mammographic and histological risk factors for breast cancer. Journal of the National Cancer Institute 1992;84(15):1170‐9.
Boyd NF, Jong RA, Yaffe MJ, Tritchler D, Lockwood G, Zylak CJ. A critical appraisal of the Canadian National Breast Cancer Screening Study. Radiology 1993;189(3):661‐3.
Boyd NF, Lockwood GA, Martin LJ, Knight JA, Jong RA, Fishell E, et al. Mammographic densities and risk of breast cancer among subjects with a family history of this disease. Journal of the National Cancer Institute 1999;91(16):1404‐8.
Boyd NF, Wolfson C, Moskowitz M, Carlile T, Petitclerc M, Ferri HA, et al. Observer variation in the interpretation of xeromammograms. Journal of the National Cancer Institute 1982;68(3):357‐63.
Bryant H. The review of randomization in the Canadian National Breast Screening Study. What does the verdict mean for clinicians?. CMAJ 1997;156(2):213‐5.
Burhenne LJ, Burhenne HJ. The Canadian National Breast Screening Study: a Canadian critique. American Journal of Roentgenology 1993;161(4):761‐3.
Busetti MC, Miller AB, To T, Rohan TE. Risk factors for breast cancer mortality among the National Breast Screening Study of Canada participants. Cancer Detection and Prevention 1996;20(2):122‐9.
Cohen MM, Kaufert PA, MacWilliam L, Tate RB. Using an alternative data source to examine randomization in the Canadian National Breast Screening Study. Journal of Clinical Epidemiology 1996;49(9):1039‐44.
Goel V, Cohen MM, Kaufert P, MacWilliam L. Assessing the extent of contamination in the Canadian National Breast Screening Study. American Journal of Preventive Medicine 1998;15(3):206‐11.
Goldman B. When considering attacks against the National Breast Screening Study, consider the sources. CMAJ 1993;148(3):427‐8.
Gray C. US resistance to Canadian mammogram study not only about data. CMAJ 1993;148(4):622‐3.
Haiart DC, Henderson J. A comparison of interpretation of screening mammograms by a radiographer, a doctor and a radiologist: results and implications. The British Journal of Clinical Practice 1991;45(1):43‐5.
Harvey BJ, Miller AB, Baines CJ, Corey PN. Effect of breast self‐examination techniques on the risk of death from breast cancer. CMAJ 1997;157(9):1205‐12.
Holowaty PH, Miller AB, Baines CJ, Risch H. Canadian National Breast Screening Study: first screen results as predictors of future breast cancer risk. Cancer Epidemiology, Biomarkers & Prevention 1993;2(1):11‐9.
Howe GR, Sherman GJ, Semenciw RM, Miller AB. Estimated benefits and risks of screening for breast cancer. Canadian Medical Association Journal 1981;124(4):399‐403.
Jain MG, Miller AB, Rohan TE, Rehm JT, Bondy SJ, Ashley MJ, et al. Body mass index and mortality in women: follow‐up of the Canadian National Breast Screening Study cohort. International Journal of Obesity and Related Metabolic Disorders 2005;29(7):792‐7.
Kopans DB, Feig SA. The Canadian National Breast Screening Study: a critical review. American Journal of Roentgenology 1993;161(4):755‐60.
Kopans DB, Halpern E, Hulka CA. Mammography screening for breast cancer. Reply to the commentaries. Cancer 1994;74(4):1212‐6.
Kopans DB, Halpern E, Hulka CA. Statistical power in breast cancer screening trials and mortality reduction among women 40‐49 years of age with particular emphasis on the National Breast Screening Study of Canada. Cancer 1994;74(4):1196‐203.
Miller AB. Canadian National Breast Screening Study: response [letter]. CMAJ 1993;149(10):1374‐5.
Miller AB. Mammography in mass screening [letter]. European Journal of Cancer 1980;16(5):737‐9.
Miller AB. More on breast cancer screening. Cancer Forum 1988;12:1‐3.
Miller AB. Re: "Author of Canadian breast cancer study retracts warnings" [letter]. Journal of the National Cancer Institute 1992;84(17):1365‐70.
Miller AB. Re: May we agree to disagree, or how do we develop guidelines for breast cancer screening in women? [letter]. Journal of the National Cancer Institute 1994;86(22):1729‐31.
Miller AB. Routine mammography and the National Breast Screening Study. CMAJ 1984;130(3):259‐60, 273.
Miller AB. The Canadian National Breast Screening Study: update on breast cancer mortality. NIH Consensus Development Conference on Breast Cancer Screening for Women ages 40‐49. National Institutes of Health, 1997:51‐3.
Miller AB. The Canadian national breast screening study. In: Day NE, Miller AB editor(s). Screening for Breast Cancer. Toronto: Hans Huber, 1988:51‐8.
Miller AB. The costs and benefits of breast cancer screening. American Journal of Preventive Medicine 1993;9(3):175‐80.
Miller AB, Baines CJ, Sickles EA. Canadian National Breast Screening Study. American Journal of Roentgenology 1990;155:1133‐4.
Miller AB, Baines CJ, To T, et al. The Canadian national breast screening study. In: Miller AB, Chamberlain J, Day NE, et al. editor(s). Cancer Screening. Cambridge: Cambridge University Press, 1991:45‐55.
Miller AB, Baines CJ, To T, Wall C. Canadian national breast screening study [correction]. CMAJ 1993;148:718.
Miller AB, Baines CJ, To T, Wall C. Screening mammography re‐evaluated. The Lancet 2000;355:747.
Miller AB, Baines CJ, Turnbull C. The role of the nurse‐examiner in the National Breast Screening Study. Canadian Journal of Public Health 1991;82(3):162‐7.
Miller AB, Howe GR, Wall C. The National Study of Breast Cancer Screening Protocol for a Canadian Randomized Controlled trial of screening for breast cancer in women. Clinical and Investigative Medicine 1981;4(3‐4):227‐58.
Narod SA. On being the right size: A reappraisal of mammography trials in Canada and Sweden. The Lancet 1997;349:1849.
Simard A, Paquette L, Baillargeon J, Falardeau M. Perception of cancer detection and early treatment in a population participating in the National Breast Screening Study in Canada. Canadian Journal of Public Health 1989;80(3):226‐7.

Canada 1980a {published and unpublished data}

Kopans DB. Canadian National Breast Screening Study [letter]. The Lancet 1997;350(9080):810.
Miller AB, Baines CJ, To T, Wall C. Canadian National Breast Screening Study: 1. Breast cancer detection and death rates among women aged 40 to 49 years. Canadian Medical Association Journal 1992;147(10):1459‐76.
Miller AB, To T, Baines CJ, Wall C. The Canadian National Breast Screening Study‐1: breast cancer mortality after 11 to 16 years of follow‐up. A randomized screening trial of mammography in women age 40 to 49 years. Annals of Internal Medicine 2002;137(5 Part 1):305‐12.
Miller AB, To T, Baines CJ, Wall C. The Canadian National Breast Screening Study: update on breast cancer mortality. Journal of the National Cancer Institute. Monographs 1997;NA(22):37‐41.

Canada 1980b {published and unpublished data}

Miller AB, Baines CJ, To T, Wall C. Canadian National Breast Screening Study: 2. Breast cancer detection and death rates among women aged 50 to 59 years. Canadian Medical Association Journal 1992;147(10):1477‐88.
Miller AB, To T, Baines CJ, Wall C. Canadian National Breast Screening Study‐2: 13‐year results of a randomized trial in women aged 50‐59 years. Journal of the National Cancer Institute 2000;92:1490‐9.

Edinburgh 1978 {published data only}

Alexander F, Roberts MM, Lutz W, Hepburn W. Randomisation by cluster and the problem of social class bias. Journal of Epidemiology and Community Health 1989;43(1):29‐36.
Alexander FE. The Edinburgh Randomized Trial of Breast Cancer Screening. Journal of the National Cancer Institute. Monographs 1997;22:31‐5.
Alexander FE, Anderson TJ, Brown HK, Forrest AP, Hepburn W, Kirkpatrick AE, et al. 14 years of follow‐up from the Edinburgh randomised trial of breast‐cancer screening. The Lancet 1999;353(9168):1903‐8.
Alexander FE, Anderson TJ, Brown HK, Forrest AP, Hepburn W, Kirkpatrick AE, et al. The Edinburgh randomised trial of breast cancer screening: results after 10 years of follow‐up. British Journal of Cancer 1994;70(3):542‐8.
Alexander FE, Anderson TJ, Donnan PT, Prescott RJ. Edinburgh trial of screening for breast cancer [letter]. The Lancet 1990;335(8695):969‐70.
Alexander FE, Anderson TJ, Donnan PT, Prescott RJ. Edinburgh trial of screening for breast cancer [letter]. The Lancet 1990;335:1290‐1.
Alexander FE, Anderson TJ, Hubbard AL. Screening status in relation to biological and chronological characteristics of breast cancers: a cross sectional survey. Journal of Medical Screening 1997;4(3):152‐7.
Alexander FE, Brown HK, Prescott RJ. Improved classification of socio‐economic status explains differences in all‐cause mortality in the randomised trial of breast cancer screening. Journal of Epidemiology and Biostatistics 1998;3(2):219‐24.
Alexander FE, O'Brien F, Hepburn W, Miller M. Association between mortality among women and socioeconomic factors in general practices in Edinburgh: an application of small area statistics. BMJ 1987;295(6601):754‐6.
Alexander FE, Roberts MM, Huggins A, Muir BB. Use of risk factors to allocate schedules for breast cancer screening. Journal of Epidemiology and Community Health 1988;42(2):193‐9.
Anderson TJ, Lamb J, Alexander F, Lutz W, Chetty U, Forrest AP, et al. Comparative pathology of prevalent and incident cancers detected by breast screening. Edinburgh Breast Screening Project. The Lancet 1986;1(8480):519‐23.
Anderson TJ, Lamb J, Donnan P, Alexander FE, Huggins A, Muir BB, et al. Comparative pathology of breast cancer in a randomised trial of screening. British Journal of Cancer 1991;64(1):108‐13.
Benjamin DJ. The efficacy of surgical treatment of breast cancer. Medical Hypotheses 1996;47(5):389‐97.
Chamberlain J, Atkinson AB, Cochrane AL. Trial of early detection of breast cancer: Description of method. British Journal of Cancer 1981;44:618‐27.
Chamberlain J, Coleman D, Ellamn R, Moss S. Progress report of the UK trial of early detection of breast cancer. In: Day NE, Miller AB editor(s). Progress report of the UK trial of early detection of breast cancer. Toronto: Hans Huber, 1988:45‐9.
Chamberlain J, Coleman D, Ellman R, Moss S, Thomas B, Price J. Sensitivity and specificity of screening in the UK trial of early detection of breast cancer. In: Miller AB, Chamberlain J, Day NE, et al. editor(s). Cancer Screening. Cambridge: Cambridge University Press, 1991:3‐17.
Chetty U, Wang CC, Forrest AP, Roberts MM. Benign breast disease and cancer. The British Journal of Surgery 1980;67(11):789‐90.
Dean C, Roberts MM, French K, Robinson S. Psychiatric morbidity after screening for breast cancer. Journal of Epidemiology and Community Health 1986;40(1):71‐5.
French K, Porter AM, Robinson SE, McCallum FM, Howie JG, Roberts MM. Attendance at a breast screening clinic: a problem of administration or attitudes. BMJ 1982;285(6342):617‐20.
Milne L. Mammography in the Edinburgh breast screening project. Radiography 1979;45(536):176‐8.
Nicholson S, Farndon JR. Edinburgh trial of screening for breast cancer [letter]. The Lancet 1990;335(8700):1290‐1.
Owen AW, Forrest AP, Anderson TJ, Samuel E, Young GB, Scott AM. Breast screening and surgical problems. The British Journal of Surgery 1977;64(10):725‐8.
Roberts MM, Alexander FE, Anderson TJ, Chetty U, Donnan PT, Forrest P, et al. Edinburgh trial of screening for breast cancer: mortality at seven years. The Lancet 1990;335(8684):241‐6.
Roberts MM, Alexander FE, Anderson TJ, Forrest AP, Hepburn W, Huggins A, et al. The Edinburgh randomised trial of screening for breast cancer: description of method. British Journal of Cancer 1984;50(1):1‐6.
Screening for breast cancer. Report from Edinburgh Breast Screening Clinic. BMJ 1978;2(6131):175‐8.
UK Trial of Early Detection of Breast Cancer Group. 16‐year mortality from breast cancer in the UK Trial of Early Detection of Breast Cancer. The Lancet 1999;353(9168):1909‐14.
UK Trial of Early Detection of Breast Cancer Group. First results on mortality reduction in the UK Trial of Early Detection of Breast Cancer. The Lancet 1988;2(8608):411‐6.
Wald NJ, Murphy P, Major P, Parkes C, Townsend J, Frost C. UKCCCR multicentre randomised controlled trial of one and two view mammography in breast cancer screening. BMJ 1995;311(7014):1189‐93.

Göteborg 1982 {published data only}

Bjurstam N, Björneld L, Warwick J, Sala E, Duffy SW, Nyström L. The Gothenburg Breast Screening Trial. Cancer 2003;97:2387‐96.
Nyström L, Andersson I, Bjurstam N, Frisell J, Nordenskjöld B, Rutqvist LE. Long‐term effects of mammography screening: updated overview of the Swedish randomised trials. The Lancet 2002;359(9310):909‐19.

Göteborg 1982a {published data only}

Bjurstam N, Bjorneld L, Duffy SW, Smith TC, Cahlin E, Erikson O, et al. The Gothenburg Breast Cancer Screening Trial: preliminary results on breast cancer mortality for women aged 39‐49. Journal of the National Cancer Institute. Monographs 1997;22:53‐5.
Bjurstam N, Bjorneld L, Duffy SW, Smith TC, Cahlin E, Eriksson O, et al. The Gothenburg breast screening trial: first results on mortality, incidence, and mode of detection for women ages 39‐49 years at randomization. Cancer 1997;80(11):2091‐9.
Bjurstam N, Björneld L, Duffy SW. The Gothenborg breast screening trial: results from 11 years followup. NIH Consensus Development Conference on Breast Cancer Screening for Women Ages 40‐49. National Institutes of Health. 1997:63‐4.
Bjurstam N, Björneld L, Duffy SW, Prevost TC. Author Reply. Cancer 1998;83(1):188‐90.
Miller AB, Baines CJ, To T. The Gothenburg breast screening trial: first results on mortality, incidence, and mode of detection for women ages 39‐49 years at randomization [letter]. Cancer 1998;83(1):186‐90.

Göteborg 1982b {published data only}

Nyström L, Rutqvist LE, Wall S, Lindgren A, Lindqvist M, Ryden S, et al. Breast cancer screening with mammography: overview of Swedish randomised trials. The Lancet 1993;341(8851):973‐8.

Kopparberg 1977 {published data only}

Bergkvist L, Tabar L, Bergstrom R, Adami HO. Epidemiologic determinants of the mammographic parenchymal pattern. A population‐based study within a mammographic screening program. American Journal of Epidemiology 1987;126(6):1075‐81.
Tabar L, Chen HH, Duffy SW, Krusemo UB. Primary and adjuvant therapy, prognostic factors and survival in 1053 breast cancers diagnosed in a trial of mammography screening. Japanese Journal of Clinical Oncology 1999;29(12):608‐16.
Tabar L, Duffy SW, Krusemo UB. Detection method, tumour size and node metastases in breast cancers diagnosed during a trial of breast cancer screening. European Journal of Cancer & Clinical Oncology 1987;23(7):959‐62.
Tabar L, Gad A. Screening for breast cancer: the Swedish trial. Radiology 1981;138(1):219‐22.
Tabar L, Gad A, Holmberg L, Ljungquist U. Significant reduction in advanced breast cancer. Results of the first seven years of mammography screening in Kopparberg, Sweden. Diagnostic Imaging in Clinical Medicine 1985;54(3‐4):158‐64.

Malmö 1976 {published data only}

Andersson I. Mammographic screening for breast carcinoma [thesis]. University of Lund, 1980.
Andersson I. Personal communication 10 Oct 2000.
Andersson I. Personal communication 12 Feb 2001.
Andersson I. Personal communication 15 June 2001.
Andersson I. Personal communication 21 June 1999.
Andersson I. Breast cancer screening in Malmo. Recent Results in Cancer Research 1984;90:114‐6.
Andersson I. Detection bias in mammographic screening for breast carcinoma. Recent Results in Cancer Research 1984;90:164‐5.
Andersson I. Radiographic screening for breast carcinoma. I. Program and primary findings in 45‐69 year old women. Acta Radiologica: Diagnosis 1981;22(2):185‐94.
Andersson I. Radiographic screening for breast carcinoma. II. Prognostic considerations on the basis of a short‐term follow‐up. Acta Radiologica: Diagnosis 1981;22(3A):227‐33.
Andersson I. Radiographic screening for breast carcinoma. III. Appearance of carcinoma and number of projections to be used at screening. Acta Radiologica: Diagnosis 1981;22(4):407‐20.
Andersson I. Överskattning av besparingar genom screening med mammografi [letter]. Läkartidningen 1996;93(32‐33):2725.
Andersson I, Andren L, Hildell J, Linell F, Ljungqvist U, Pettersson H. Breast cancer screening with mammography: a population‐based, randomized trial with mammography as the only screening mode. Radiology 1979;132(2):273‐6.
Andersson I, Aspegren K, Janzon L, Landberg T, Lindholm K, Linell F, et al. Mammographic screening and mortality from breast cancer: the Malmo mammographic screening trial. BMJ 1988;297(6654):943‐8.
Andersson I, Hellstrom L, Bjurstam N, Lundgren B, Fagerberg G, Tabar L. Bröstcancerscreening med mammografi i Sverige. Läkartidningen 1983;80(25):2559‐62.
Andersson I, Janzon L. Reduced breast cancer mortality in women under age 50: updated results from the Malmo Mammographic Screening Program. Journal of the National Cancer Institute. Monographs 1997;22:63‐7.
Andersson I, Janzon L. Screening with mammography ‐ a critical attitude is supported by new findings. Läkartidningen 1988;85(44):3666‐9.
Andersson I, Janzon L, Pettersson H. Radiographic patterns of the mammary parenchyma: variation with age at examination and age at first birth. Radiology 1981;138(1):59‐62.
Andersson I, Janzon L, Sigfusson BF. Mammographic breast cancer screening ‐ a randomized trial in Malmo, Sweden. Maturitas 1985;7(1):21‐9.
Andersson I, Nystrom L. Mammography screening [letter]. Journal of the National Cancer Institute. Monographs 1995;87(16):1263‐4.
Andersson I, Sigfusson BF. Screening for breast cancer in Malmo: a randomized trial. Recent Results in Cancer Research 1987;105:62‐6.
Garne JP, Aspegren K, Balldin G, Ranstam J. Increasing incidence of and declining mortality from breast carcinoma. Trends in Malmo, Sweden, 1961‐1992. Cancer 1997;79(1):69‐74.
Gullberg B, Andersson I, Janzon L, Ranstam J. Screening mammography [letter]. The Lancet 1991;337(8735):244.
Ikeda DM, Andersson I, Wattsgard C, Janzon L, Linell F. Interval carcinomas in the Malmo Mammographic Screening Trial: radiographic appearance and prognostic considerations. AJR. American Journal of Roentgenology 1992;159(2):287‐94.
Janzon L, Andersson I. The Malmö mammographic screening trial. In: Miller AB, Chamberlain J, Day NE, et al. editor(s). Cancer Screening. Cambridge: Cambridge University Press, 1991:37‐44.
Ringberg A, Andersson I, Aspegren K, Linell F. Breast carcinoma in situ in 167 women‐incidence, mode of presentation, therapy and follow‐up. European Journal of Surgical Oncology 1991;17(5):466‐76.

Malmö II 1978 {published data only}

Andersson I, Janzon L. Reduced breast cancer mortality in women under age 50: updated results from the Malmo Mammographic Screening Program. Journal of the National Cancer Institute. Monographs 1997;22:63‐7.

New York 1963 {published data only}

Aron JL, Prorok PC. An analysis of the mortality effect in a breast cancer screening study. Journal of the National Cancer Institute. Monographs 1986;15:36‐43.
Chu KC, Connor RJ. Analysis of the temporal patterns of benefits in the Health Insurance Plan of Greater New York trial by stage and age. American Journal of Epidemiology 1991;133(10):1039‐49.
Chu KC, Smart CR, Tarone RE. Analysis of breast cancer mortality and stage distribution by age for the Health Insurance Plan clinical trial. Journal of the National Cancer Institute 1988;80(14):1125‐32.
Connor RJ, Prorok PC, Weed DL. The case‐control design and the assessment of the efficacy of cancer screening. Journal of Clinical Epidemiology 1991;44(11):1215‐21.
Final reports of National Cancer Institute ad hoc working groups on mammography screening for breast cancer and a summary report of their joint findings and recommendations. DHEW Publication No. (NIH) 77 1400. US Department of Health, Education and Welfare, 1977.
Fink R, Shapiro S. Significance of increased efforts to gain participation in screening for breast cancer. American Journal of Preventive Medicine 1990;6(1):34‐41.
Fink R, Shapiro S, Lewison J. The reluctant participant in a breast cancer screening program. Public Health Reports 1968;83(6):479‐90.
Fink R, Shapiro S, Roester R. Impact of efforts to increase participation in repetitive screenings for early breast cancer detection. American Journal of Public Health 1972;62(3):328‐36.
Friedman DR, Dubin N. Case‐control evaluation of breast cancer screening efficacy. American Journal of Epidemiology 1991;133(10):974‐84.
Habbema JD, van Oortmarssen GJ, van Putten DJ. An analysis of survival differences between clinically and screen‐detected cancer patients. Statistics in Medicine 1983;2(2):279‐85.
Habbema JD, van Oortmarssen GJ, van Putten DJ, Lubbe JT, van der Maas PJ. Age‐specific reduction in breast cancer mortality by screening: an analysis of the results of the Health Insurance Plan of Greater New York study. American Journal of Epidemiology 1986;77(2):317‐20.
Shapiro S. Determining the efficacy of breast cancer screening. Cancer 1989;63(10):1873‐80.
Shapiro S. Evaluation of two contrasting types of screening programs. Preventive Medicine 1973;2(2):266‐77.
Shapiro S. Evidence on screening for breast cancer from a randomized trial. Cancer 1977;39(6 Suppl):2772‐82.
Shapiro S. Periodic screening for breast cancer: the HIP Randomized Controlled Trial. Health Insurance Plan. Journal of the National Cancer Institute. Monographs 1997;22:27‐30.
Shapiro S. Screening: assessment of current studies. Cancer 1994;74 Suppl(1):231‐8.
Shapiro S. The status of breast cancer screening: a quarter of a century of research. World Journal of Surgery 1989;13(1):9‐18.
Shapiro S, Goldberg JD, Hutchison GB. Lead time in breast cancer detection and implications for periodicity of screening. American Journal of Epidemiology 1974;100(5):357‐66.
Shapiro S, Strax P, Venet L. Evaluation of periodic breast cancer screening with mammography. Methodology and early observations. JAMA 1966;195(9):731‐8.
Shapiro S, Strax P, Venet L. Evaluation of periodic breast cancer screening with mammography: methodology and early observations. 1966 [classical article]. CA: A Cancer Journal for Clinicians 1990;40(2):111‐25.
Shapiro S, Strax P, Venet L. Periodic breast cancer screening in reducing mortality from breast cancer. JAMA 1971;215(11):1777‐85.
Shapiro S, Strax P, Venet L, Fink R. The search for risk factors in breast cancer. American Journal of Public Health and the Nation's Health 1968;58(5):820‐35.
Shapiro S, Strax P, Venet L, Venet W. Changes in 5‐year breast cancer mortality in a breast cancer screening program. Proceedings. National Cancer Conference 1972;7:663‐78.
Shapiro S, Venet W, Strax P, Venet L. Periodic screening for breast cancer: The health insurance plan project and its sequelae, 1963‐1986. Baltimore: Johns Hopkins University Press, 1988:The health insurance plan project and its sequelae.
Shapiro S, Venet W, Strax P, Venet L. Current results of the breast cancer screening randomized trial: The health insurance plan (HIP) of greater New York study. In: Day NE, Miller AB editor(s). Screening for breast cancer. Toronto: Hans Huber, 1988:3‐15.
Shapiro S, Venet W, Strax P, Venet L, Roeser R. Prospects for eliminating racial differences in breast cancer survival rates. American Journal of Public Health 1982;72(10):1142‐5.
Shapiro S, Venet W, Strax P, Venet L, Roeser R. Selection, follow‐up, and analysis in the Health Insurance Plan Study: a randomized trial with breast cancer screening. Journal of the National Cancer Institute. Monographs 1985;67:65‐74.
Shapiro S, Venet W, Strax P, Venet L, Roeser R. Ten‐ to fourteen‐year effect of screening on breast cancer mortality. Journal of the National Cancer Institute 1982;69(2):349‐55.
Smart CR. Highlights of the evidence of benefit for women aged 40‐49 years from the 14‐year follow‐up of the Breast Cancer Detection Demonstration Project. Cancer 1994;74(1 Suppl):296‐300.
Strax P. Advances in detection of early breast cancer. Cancer Detection and Prevention 1983;6(4‐5):409‐14.
Strax P. Benefit of breast cancer screening on morbidity and mortality. In: Bostrom H, et al. editor(s). Health control in detection of cancer. Stockholm: Almqvist and Wiksell, 1976:133‐45.
Strax P. Mass screening for control of breast cancer. Cancer 1984;53(3 Suppl):665‐70.
Strax P. Physical methods in breast cancer diagnosis. Israel Journal of Medical Sciences 1981;17(9‐10):847‐53.
Strax P, Venet L, Shapiro S. Mass screening in mammary cancer. Cancer 1969;23(4):875‐8.
Strax P, Venet L, Shapiro S. Value of mammography in reduction of mortality from breast cancer in mass screening. The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine 1973;117(3):686‐9.
Strax P, Venet L, Shapiro S, Gross S. Mammography and clinical examination in mass screening for cancer of the breast. Cancer 1967;20(12):2184‐8.
Strax P, Venet L, Shapiro S, Gross S, Venet W. Breast cancer found on repetitive examination in mass screening. Archives of Environmental Health 1970;20(6):758‐63.
Thomas LB, Ackerman LV, McDivitt RW, Hanson TAS, Hankey BF, Prorok PC. Report of NCI ad hoc pathology working group to review the gross and microscopic findings of breast cancer cases in the HIP study. Journal of the National Cancer Institute 1977;59(2):496‐541.

Östergötland 1978 {published data only}

Arnesson LG, Fagerberg G, Grontoft O, Lundstrom B. Surgical biopsy of non‐palpable mammary lesions. Technique and results. Acta Chirurgica Scandinavica 1986;152:97‐101.
Arnesson LG, Smeds S, Fagerberg G. Recurrence‐free survival in patients with small breast cancer. An analysis of cancers 10 mm or less detected clinically and by screening. The European Journal of Surgery 1994;160(5):271‐6.
Arnesson LG, Smeds S, Fagerberg G, Grontoft O. Follow‐up of two treatment modalities for ductal cancer in situ of the breast. The British Journal of Surgery 1989;76(7):672‐5.
Arnesson LG, Smeds S, Hatschek T, Nordenskjold B, Fagerberg G. Hormone receptors, ploidy and proliferation rate in breast cancers up to 10 mm. European Journal of Surgical Oncology 1992;18(3):235‐40.
Arnesson LG, Vitak B, Manson JC, Fagerberg G, Smeds S. Diagnostic outcome of repeated mammography screening. World Journal of Surgery 1995;19(3):372‐7.
Fagerberg G. Experience from randomized controlled breast screening with mammography in Ostergotland county, Sweden: a preliminary report. Recent Results in Cancer Research 1984;90:117.
Fagerberg G, Baldetorp L, Grontoft O, Lundstrom B, Manson JC, Nordenskjold B. Effects of repeated mammographic screening on breast cancer stage distribution. Results from a randomised study of 92 934 women in a Swedish county. Acta Chirurgica Scandinavica 1985;24(6):465‐73.
Hatschek T, Carstensen J, Fagerberg G, Stal O, Grontoft O, Nordenskjold B. Influence of S‐phase fraction on metastatic pattern and post‐recurrence survival in a randomized mammography screening trial. Breast Cancer Research and Treatment 1989;14(3):321‐7.
Hatschek T, Fagerberg G, Stal O, Sullivan S, Carstensen J, Grontoft O, et al. Cytometric characterization and clinical course of breast cancer diagnosed in a population‐based screening program. Cancer 1989;64(5):1074‐81.
Hatschek T, Grontoft O, Fagerberg G, Stal O, Sullivan S, Carstensen J, et al. Cytometric and histopathologic features of tumors detected in a randomized mammography screening program: correlation and relative prognostic influence. Breast Cancer Research and Treatment 1990;15(3):149‐60.
Lundström B, Fagerberg G. Clinical problems in relation to breast cancer screening with mammography. A preliminary report. Acta Chirurgica Scandinavica. Supplementum 1984;519:61‐3.
Vitak B. Invasive interval cancers in the Ostergotland Mammographic Screening Programme: radiological analysis. European Radiology 1998;8(4):639‐46.

Stockholm 1981 {published data only}

Frisell J. Mammographic screening for breast cancer [thesis]. Stockholm: Södersjukhuset, 1989. [ISBN: 91‐7900‐659‐0]
Frisell J. Personal communication 13 Nov 2000.
Frisell J. Personal communication 16 Nov 2000.
Frisell J, Eklund G, Hellstrom L, Glas U, Somell A. The Stockholm breast cancer screening trial ‐ 5‐year results and stage at discovery. Breast Cancer Research and Treatment 1989;13(1):79‐87.
Frisell J, Eklund G, Hellstrom L, Lidbrink E, Rutqvist LE, Somell A. Randomized study of mammography screening ‐ preliminary report on mortality in the Stockholm trial. Breast Cancer Research and Treatment 1991;18(1):49‐56.
Frisell J, Eklund G, Hellstrom L, Somell A. Analysis of interval breast carcinomas in a randomized screening trial in Stockholm. Breast Cancer Research and Treatment 1987;9(3):219‐25.
Frisell J, Eklund G, Nilsson R, Hellstrom L, Somell A. Additional value of fine‐needle aspiration biopsy in a mammographic screening trial. The British Journal of Surgery 1989;76(8):840‐3.
Frisell J, Glas U, Hellstrom L, Somell A. Randomized mammographic screening for breast cancer in Stockholm. Design, first round results and comparisons. Breast Cancer Research and Treatment 1986;8(1):45‐54.
Frisell J, Lidbrink E. The Stockholm Mammographic Screening Trial: Risks and benefits in age group 40‐49 years. Journal of the National Cancer Institute. Monographs 1997;22:49‐51.
Frisell J, Lidbrink E, Hellstrom L, Rutqvist LE. Followup after 11 years ‐ update of mortality results in the Stockholm mammographic screening trial. Breast Cancer Research and Treatment 1997;45(3):263‐70.
Frisell J, von Rosen A, Wiege M, Nilsson B, Goldman S. Interval cancer and survival in a randomized breast cancer screening trial in Stockholm. Breast Cancer Research and Treatment 1992;24(1):11‐6.
Lidbrink E, Elfving J, Frisell J, Jonsson E. Neglected aspects of false positive findings of mammography in breast cancer screening: analysis of false positive cases from the Stockholm trial. BMJ 1996;312(7026):273‐6.
Lidbrink E, Frisell J, Brandberg Y, Rosendahl I, Rutqvist LE. Nonattendance in the Stockholm mammography screening trial: relative mortality and reasons for nonattendance. Breast Cancer Research and Treatment 1995;35(3):267‐75.
von Rosen A, Frisell J, Glas U, Hellstrom L, Nilsson R, Skoog L, et al. Non‐palpable invasive breast carcinomas from the Stockholm screening project. Acta Oncologica (Stockholm, Sweden) 1989;28(1):23‐7.
von Rosen A, Frisell J, Nilsson R, Wiege M, Auer G. Histopathologic and cytochemical characteristics of interval breast carcinomas from the Stockholm Mammography Screening Project. Acta Oncologica (Stockholm, Sweden) 1992;31(4):399‐402.

Two‐County 1977 {published data only}

Summary of the discussion on breast cancer screening. In: Miller AB, Chamberlain J, Day NE, et al. editor(s). Cancer screening. Cambridge: Cambridge University Press, 1991:78‐80.
Chen HH, Tabar L, Fagerberg G, Duffy SW. Effect of breast cancer screening after age 65. Journal of Medical Screening 1995;2(1):10‐4.
Day NE. Surrogate measures in the design of breast screening trials. In: Miller AB, Chamberlain J, Day NE, et al. editor(s). Cancer Screening. Cambridge: Cambridge University Press, 1991:391‐403.
Day NE, Williams DR, Khaw KT. Breast cancer screening programmes: the development of a monitoring and evaluation system. British Journal of Cancer 1989;59(6):954‐8.
Duffy S, Tabar L, Krusemo UB, Day N. Randomization by cluster in the Swedish two‐county trial: recent results from Kopparberg and implications for interpretation [abstract]. Nordic Cancer Union 1989, Symposium in Stockholm 17‐19 Aug1989.
Duffy SW, Chen HH, Tabar L, Fagerberg G, Paci E. Sojourn time, sensitivity and positive predictive value of mammography screening for breast cancer in women aged 40‐49. International Journal of Epidemiology 1996;25(6):1139‐45.
Duffy SW, Day NE, Tabar L, Chen HH, Smith TC. Markov models of breast tumor progression: some age‐specific results. Journal of the National Cancer Institute. Monographs 1997;22:93‐7.
Duffy SW, South MC, Day NE. Cluster randomization in large public health trials: the importance of antecedent data. Statistics in Medicine 1992;11(3):307‐16.
Duffy SW, Tabar L. Screening for breast cancer [letter]. The Lancet 1995;346(8978):852.
Duffy SW, Tabar L, Fagerberg G, Gad A, Grontoft O, South MC, et al. Breast screening, prognostic factors and survival ‐ results from the Swedish two county study. British Journal of Cancer 1991;64(6):1133‐8.
Duffy SW, Tabar L, Vitak B, Yen MF, Warwick J, Smith RA, et al. The Swedish Two‐County Trial of mammographic screening: cluster randomisation and end point evaluation. Annals of Oncology 2003;14(8):1196‐8.
Duffy SW, Tabar L, Vitak B, et al. The Swedish Two‐County Trial of mammographic screening: cluster randomisation and end point evaluation. Annals of Oncology 2003;14(8):1196‐8.
Fagerberg CJG, Tabar L. The results of periodic one‐view mammography screening in a randomized, controlled trial in Sweden. In: Day NE, Miller AB editor(s). Screening for breast cancer. Toronto: Hans Huber, 1988:33‐8.
Holmberg L, Adami HO, Lundstrom T, Persson I, Tabar L. [Mass screening mammography results in an increased need for surgical wards]. Läkartidningen 1986;83(22):2047‐9.
Holmberg L, Adami HO, Persson I, Lundstrom T, Tabar L. Demands on surgical inpatient services after mass mammographic screening. BMJ 1986;293(6550):779‐82.
Holmberg LH, Tabar L, Adami HO, Bergstrom R. Survival in breast cancer diagnosed between mammographic screening examinations. The Lancet 1986;2(8497):27‐30.
Nixon R, Prevost TC, Duffy SW, Tabar L, Vitak B, Chen HH. Some random‐effects models for the analysis of matched‐cluster randomised trials: application to the Swedish two‐county trial of breast‐cancer screening. Journal of Epidemiology and Biostatistics 2000;5(6):349‐58.
Nixon RM, Pharoah P, Tabar L, et al. Mammographic screening in women with a family history of breast cancer: some results from the Swedish two‐county trial. Revue D'épidémiologie et de Santé Publique 2000;48(4):325‐31.
Projektgruppen för WE‐studien i Kopparbergs och Östergötlands län samt socialstyrelsens bearbetningsgrupp för WE‐projektet. Reply on mammography [Replik om mammografi]. Läkartidningen 1985;82:2674.
Prorok PC. Personal communication 2 Feb 2000.
Rapport över mammografiscreening i Kopparbergs och Östergötlands läns landsting (WE‐projektet) ‐ Resultat efter första screeningsomgången. Unknown. Stockholm: Socialstyrelsen, 1982.
Socialstyrelsens beredningsgrupp för WE‐projektet. Minskad mortalitet i bröstcancer genom hälskontroll med mammografi. Nordisk Medicin 1985;100:175‐8.
Tabar L. Personal communication 17 Jan 2000.
Tabar L. Mammografins förmåga finna högriskfallen ar nyckelfrågan [letter]. Läkartidningen 1996;93(38):3221.
Tabar L. SBUs aktuella statistik inaktuell [letter]. Läkartidningen 1995;92(48):4540‐1.
Tabar L, Akerlund E, Gad A. Five‐year experience with single‐view mammography randomized controlled screening in Sweden. Recent Results in Cancer Research 1984;90:105‐13.
Tabar L, Chen HH, Fagerberg G, Duffy SW, Smith TC. Recent results from the Swedish Two‐County Trial: the effects of age, histologic type, and mode of detection on the efficacy of breast cancer screening. Journal of the National Cancer Institute. Monographs 1997;22:43‐7.
Tabar L, Duffy SW. Criticisms of Swedish mammography trials were wrong [letter]. BMJ 1999;319:1367.
Tabar L, Duffy SW, Burhenne LW. New Swedish breast cancer detection results for women aged 40‐49. Cancer 1993;72 Suppl(4):1437‐48.
Tabar L, Duffy SW, Chen HH. Quantitative interpretation of age‐specific mortality reductions from the Swedish Breast Cancer‐Screening Trials [letter]. Journal of the National Cancer Institute 1996;88(1):52‐5.
Tabar L, Duffy SW, Day NE. Screening with mammography [letter]. International Journal of Technology Assessment in Health Care 1990;6(3):498‐500.
Tabar L, Duffy SW, Yen MF, Warwick J, Vitak B, Chen HH, et al. All‐cause mortality among breast cancer patients in a screening trial: support for breast cancer mortality as an end point. Journal of Medical Screening 2002;9(4):159‐62.
Tabar L, Duffy SW, Yen MF, et al. All‐cause mortality among breast cancer patients in a screening trial: support for breast cancer mortality as an end point. Journal of Medical Screening 2002;9(4):159‐62.
Tabar L, Faberberg G, Day NE, Holmberg L. What is the optimum interval between mammographic screening examinations? An analysis based on the latest results of the Swedish two‐county breast cancer screening trial. British Journal of Cancer 1987;55(5):547‐51.
Tabar L, Fagerberg CJ, Gad A, Baldetorp L, Holmberg LH, Grontoft O, et al. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. The Lancet 1985;1(8433):829‐32.
Tabar L, Fagerberg CJG, Day NE. The results of periodic one‐view mammographic screening in Sweden. Part 2: Evaluation of the results. In: Day NE, Miller AB editor(s). Screening for breast cancer. Toronto: Hans Huber, 1988:39‐44.
Tabar L, Fagerberg CJG, South MC, Day NE, Duffy SW. The Swedish Two‐county Trial of mammographic screening for breast cancer: recent results on mortality and tumour characteristics. In: Miller AB, Chamberlain J, Day NE, et al. editor(s). Cancer screening. Cambridge University Press: Cambridge University Press, 1991:23‐36.
Tabar L, Fagerberg G, Chen HH, Duffy SW, Gad A. Screening for breast cancer in women aged under 50: mode of detection, incidence, fatality, and histology. Journal of Medical Screening 1995;2(2):94‐8.
Tabar L, Fagerberg G, Chen HH, Duffy SW, Gad A. Tumour development, histology and grade of breast cancers: prognosis and progression. International Journal of Cancer 1996;66(4):413‐9.
Tabar L, Fagerberg G, Chen HH, Duffy SW, Smart CR, Gad A, et al. Efficacy of breast cancer screening by age. New results from the Swedish Two‐County Trial. Cancer 1995;75(10):2507‐17.
Tabar L, Fagerberg G, Day NE, Duffy SW. The Swedish two‐county trial of mammographic screening for breast cancer: recent results on mortality and tumor characteristics. Pathologie‐Biologie 1992;39(9):846.
Tabar L, Fagerberg G, Day NE, Duffy SW, Kitchin RM. Breast cancer treatment and natural history: new insights from results of screening. The Lancet 1992;339(8790):412‐4.
Tabar L, Fagerberg G, Duffy SW, Day NE. Mammografi minskar dödligheten i bröstcancer signifikant. Läkartidningen 1990;87(1‐2):36‐9.
Tabar L, Fagerberg G, Duffy SW, Day NE. The Swedish two county trial of mammographic screening for breast cancer: recent results and calculation of benefit. Journal of Epidemiology and Community Health 1989;43(2):107‐14.
Tabar L, Fagerberg G, Duffy SW, Day NE, Gad A, Grontoft O. Update of the Swedish two‐county program of mammographic screening for breast cancer. Radiologic Clinics of North America 1992;30(1):187‐210.
Tabar L, Gad A, Akerlund E, Fors B, Fagerberg G, Baldetorp L. Screening for breast cancer in Sweden. A randomised controlled trial. In: Logan WW, Muntz EP editor(s). Reduced dose mammography. New York: Masson, 1979:407‐14.
Tabar L, Smith RA, Vitak B, et al. Mammographic screening: a key factor in the control of breast cancer. Cancer Journal (Sudbury, Mass.) 2003;9(1):15‐27.
Tabar L, Vitak B, Chen HH, et al. The Swedish Two‐County Trial twenty years later. Updated mortality results and new insights from long‐term follow‐up. Radiologic Clinics of North America 2000;38(4):625‐51.
Tabar L, Vitak B, Chen HH, Prevost TC, Duffy SW. Update of the Swedish Two‐County Trial of breast cancer screening: histologic grade‐specific and age‐specific results. Swiss Surgery 1999;5(5):199‐204.
Tabar L, Vitak B, Yen MF, Chen HH, Smith RA, Duffy SW. Number needed to screen: lives saved over 20 years of follow‐up in mammographic screening. Journal of Medical Screening 2004;11(3):126‐9.
Warwick J, Tabar L, Vitak B, Duffy SW. Time‐dependent effects on survival in breast carcinoma: results of 20 years of follow‐up from the Swedish Two‐County Study. Cancer 2004;100(7):1331‐6.

UK age trial 1991 {published data only}

Johns LE, Moss SM. False‐positive results in the randomized controlled trial of mammographic screening from age 40 ("Age" trial). Cancer Epidemiology Biomarkers and Prevention 2010;19:2758‐64.
Johns LE, Moss SM. Randomized controlled trial of mammographic screening from age 40 ('Age' trial): patterns of screening attendance. J Med Screen 2010; 17(1):37‐43.. Journal of Medical Screening 2010;17:37‐43.
Moss S. A trial to study the effect on breast cancer mortality of annual mammographic screening in women starting at age 40. Trial Steering Group. Journal of Medical Screening 1999;6(3):144‐8.
Moss S, Thomas I, Evans A, Thomas B, Johns L. Randomised controlled trial of mammographic screening in women from age 40: results of screening in the first 10 years. British Journal of Cancer 2005;92:949‐54.
Moss S, Waller M, Anderson TJ, Cuckle H. Randomised controlled trial of mammographic screening in women from age 40: predicted mortality based on surrogate outcome measures. British Journal of Cancer 2005;92:955‐60.
Moss SM, Cuckle H, Evans A, Johns L, Waller M, Bobrow L, for the Trial Management Group. Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years' follow‐up: a randomised controlled trial. The Lancet 2006;368:2053‐60.

References to studies excluded from this review

Ir a:

Berglund 2000 {published data only}

Berglund G, Nilsson P, Eriksson K F, Nilsson J A, Hedblad B, Kristenson H, et al. Long‐term outcome of the Malmo preventive project: mortality and cardiovascular morbidity. Journal of Internal Medicine 2000;247:19‐29.

Dales 1979 {published data only}

Dales LG, Friedman GD, Collen MF. Evaluating periodic multiphasic health checkups: a controlled trial. Journal of Chronic Diseases 1979;32:385‐404.

Singapore 1994 {published data only}

Ng EH, Ng FC, Tan PH, Low SC, Chiang G, Tan KP, et al. Results of intermediate measures from a population‐based, randomized trial of mammographic screening prevalence and detection of breast carcinoma among Asian women: the Singapore Breast Screening Project. Cancer 1998;82(8):1521‐8.

Alexander 1989

Alexander F, Roberts MM, Lutz W, Hepburn W. Randomisation by cluster and the problem of social class bias. Journal of Epidemiology and Community Health 1989;43(1):29‐36.

Alexander 1994

Alexander FE, Anderson TJ, Brown HK, Forrest AP, Hepburn W, Kirkpatrick AE, et al. The Edinburgh randomised trial of breast cancer screening: results after 10 years of follow‐up. British Journal of Cancer 1994;70(3):542‐8.

Alexander 1999

Alexander FE, Anderson TJ, Brown HK, Forrest AP, Hepburn W, Kirkpatrick AE, et al. 14 years of follow‐up from the Edinburgh randomised trial of breast‐cancer screening. The Lancet 1999;353(9168):1903‐8.

Alexander 2000

Alexander F. Personal communication 3 Oct 2000.

Andersson 1980

Andersson I. Mammographic screening for breast carcinoma [thesis]. University of Lund, 1980.

Andersson 1981

Andersson I. Radiographic screening for breast carcinoma. I. Program and primary findings in 45‐69 year old women. Acta Radiologica: Diagnosis 1981;22(2):185‐94.

Andersson 1981a

Andersson I. Radiographic screening for breast carcinoma. II. Prognostic considerations on the basis of a short‐term follow‐up. Acta Radiologica: Diagnosis 1981;22(3A):227‐33.

Andersson 1983

Andersson I, Hellstrom L, Bjurstam N, Lundgren B, Fagerberg G, Tabar L. Bröstcancerscreening med mammografi i Sverige. Läkartidningen 1983;80(25):2559‐62.

Andersson 1988

Andersson I, Aspegren K, Janzon L, Landberg T, Lindholm K, Linell F, et al. Mammographic screening and mortality from breast cancer: the Malmo mammographic screening trial. BMJ 1988;297(6654):943‐8.

Andersson 1988a

Andersson I, Janzon L. Mammografi för screening ‐ kritisk inställning stöds av nya fynd [Screening with mammography ‐ a critical attitude is supported by new findings]. Läkartidningen 1988;85(44):3666‐9.

Andersson 1997

Andersson I, Janzon L. Reduced breast cancer mortality in women under age 50: updated results from the Malmo Mammographic Screening Program. Journal of the National Cancer Institute 1997;22:63‐7.

Andersson 1999a

Anderssson I. Personal communication 15 June 1999.

Andersson 1999b

Andersson I. Personal communication 21 June 1999.

Andersson 2000

Andersson I. Personal communication 10 Oct 2000.

Andersson 2001

Andersson I. Personal communication 12 Feb 2001.

Armstrong 2007

Armstrong K, Moye E, Williams S, Berlin JA, Reynolds EE. Screeningmammography in women 40 to 49 years of age: a systematic review for the American College of Physicians. Annals of Internal Medicine 2007;146:516‐26.

Arnesson 1995

Arnesson LG, Vitak B, Manson JC, Fagerberg G, Smeds S. Diagnostic outcome of repeated mammography screening. World Journal of Surgery 1995;19(3):372‐7.

Aron 1986

Aron J, Prorok PC. An analysis of the mortality effect in a breast cancer screening study. International Journal of Epidemiology 1986;15:36‐43.

Atterstam 1999

Atterstam I. Nil [Ohederliga arbetsmetoder undergräver mammografiresultat]. Svenska Dagbladet 1999, 21. juli; Vol. sect 1:6.

Autier 2010

Autier P, Boniol M, LaVecchia C, Vatten L, Gavin A, Hery C, et al. Disparities in breast cancer mortality trends between 30 European countries: retrospective trend analysis of WHO mortality database. BMJ 2010;341:c3620.

Autier 2011

Autier P, Boniol M, Middleton R, Doré JF, Héry C, Zheng T, et al. Advanced breast cancer incidence following population based mammographic screening. Annals of Oncology 2011;22(8):1726‐35.

Autier 2011a

Autier P, Boniol M, Gavin A, Vatten LJ. Breast cancer mortality in neighbouring European countries with different levels of screening but similar access to treatment: trend analysis of WHO mortality database. BMJ 2011;343:d4411.

Bailar 1997

Bailar JC, MacMahon B. Randomization in the Canadian National Breast Screening Study: a review for evidence of subversion. Canadian Medical Association Journal 1997;156(2):193‐9.

Baines 1994

Baines CJ. The Canadian National Breast Screening Study: a perspective on criticisms. Annals of Internal Medicine 1994;120(4):326‐34.

Baines 1995

Baines CJ. The Canadian National Breast Screening Study. Why? What next? And so what?. Cancer 1995;76 Suppl(10):2107‐12.

Baines 1997

Baines CJ, Miller AB. Mammography versus clinical examination of the breasts. Journal of the National Cancer Institute. Monographs 1997;22:125‐9.

Baines 2001

Baines CJ. Personal communication 18 Jan 2001.

Baines 2005

Baines CJ. Personal communication 30 Nov 2005.

Barratt 1997

Barratt AL, Cockburn J, Redman S, Paul C, Perkins J. Mammographic screening: results from the 1996 National Breast Health Survey. The Medical Journal of Australia 1997;167:521‐4.

Barratt 1999

Barratt A, Cockburn J, Furnival C, McBride A, Mallon L. Perceived sensitivity of mammographic screening: women's views on test accuracy and financial compensation for missed cancers. Journal of Epidemiology and Community Health 1999;53:716‐20.

Barratt 2005

Barratt A, Howard K, Irwig L, Salkeld G, Houssami N. Model of outcomes of screening mammography: information to support informed choices. BMJ 2005;330:936‐8.

Barton 2001

Barton MB, Moore S, Polk S, Shtatland E, Elmore JG, Fletcher SW. Increased patient concern after false‐positive mammograms: clinician documentation and subsequent ambulatory visits. Journal of General Internal Medicine 2001;16:150‐6.

BASO audit 2000

NHS cancer screening programmes. BASO Breast Audit 1999/2000. www.cancerscreening.nhs.uk/breastscreen/publications.html (accessed Dec 12, 2001).

Baum 2000

Baum M, Tobias JS. Investment in treatment would be more effective (letter). BMJ 2000;321:1528.

Benjamin 1996

Benjamin DJ. The efficacy of surgical treatment of breast cancer. Medical Hypotheses 1996;47(5):389‐97.

Berry 1998

Berry DA. Benefits and risks of screening mammography for women in their forties: a statistical appraisal. Journal of the National Cancer Institute 1998;90:1431‐9.

Berry 2002

Berry DA. The Utility of Mammography for Women 40 to 50 Years of Age (Con). In: DeVita VT, Hellman S, Rosenberg SAe editor(s). Progress in Oncology. Sudbury: Jones and Bartlett, 2002:346‐72.

Berry 2005

Berry DA, Cronin KA, Plevritis SK, Fryback DG, Clarke L, Zelen M, et al. Effect of screening and adjuvant therapy on mortality from breast cancer. New England Journal of Medicine 2005;353:1784‐92.

Bjurstam 1997

Bjurstam N, Bjorneld L, Duffy SW, Smith TC, Cahlin E, Eriksson O, et al. The Gothenburg breast screening trial: first results on mortality, incidence, and mode of detection for women ages 39‐49 years at randomization. Cancer 1997;80(11):2091‐9.

Bjurstam 2000

Bjurstam N. Personal communication 10 Oct 2000.

Bjurstam 2003

Bjurstam N, Björneld L, Warwick J, Sala E, Duffy SW, Nyström L. The Gothenburg Breast Screening Trial. Cancer 2003;97:2387‐96.

Blamey 2000

Blamey RW, Wilson ARM, Patnick J. ABC of breast diseases: screening for breast cancer. BMJ 2000;321:689‐93.

Blamey 2007

Blamey RW, Ellis IO, Pinder SE, Lee AHS, Macmillan RD, Morgan DAL, et al. Survival of invasive breast cancer according to the Nottingham Prognostic Index in cases diagnosed in 1990‐1999. European Journal of Cancer 2007;43:1548‐55.

Bleyer 2011

Bleyer A. US breast cancer mortality is consistent with European data. BMJ 2011;343:d5630.

Bleyer 2012

Bleyer A, Welch HG. Effect of three decades of screening mammography on breast‐cancer incidence. New England Journal of Medicine 2012;367:1998‐2005.

Brett 2001

Brett J, Austoker J. Women who are recalled for further investigation for breast screening: psychological consequences 3 years after recall and factors affecting re‐attendance. Journal of Public Health Medicine 2001;23(4):292‐300.

Brodersen 2006

Brodersen J. Measuring psychosocial consequences of false‐positive screening results ‐ breast cancer as an example (PhD thesis). Institute of Public Health, Faculty of Health Sciences, Department of General Practice, University of Copenhagen. (http://cms.ku.dk/sund‐sites/ifsv‐sites/ifsv‐inst/ominstituttet/afdelinger/almen_medicin/medarbejdere/publicationdetail/?id=1109837)2006.

Brodersen 2007

Brodersen J, Thorsen H, Kreiner S. Validation of a condition‐specific measure for women having an abnormal screening mammography. Value in Health 2007;10:294‐304.

Brodersen 2013

Brodersen J, Siersma V. Long‐term psychosocial consequences of false‐positive screening mammography – a cohort study with 3‐year follow‐up. Annals of Family Medicine 2013;11(2):106‐15.

Brown 1993

Brown BW, Brauner C, Minnotte MC. Noncancer deaths in white adult cancer patients. Journal of the National Cancer Institute 1993;85(12):979‐87.

Burton 2011

Burton RC, Bell RJ, Thiagarajah G, Stevenson C. Adjuvant therapy, not mammographic screening, accounts for most of the observed breast cancer specific mortality reductions in Australian women since the national screening program began in 1991. Breast Cancer Research and Treatment 2012;131(3):949‐55.

Bülow 2000

Bülow B von. Psykologiske følger af screening for brystkræft blandt raske kvinder. Ugeskrift for Laeger 2000;162:1053‐9.

Castells 2006

Castells X, Molins E, Macia F. Cumulative false positive recall rate and association with participant related factors in a population based breast cancer screening programme. Journal of Epidemiology and Community Health 2006;60:316‐21.

Chamberlain 1981

Chamberlain J, Atkinson AB, Cochrane AL. Trial of early detection of breast cancer: Description of method. British Journal of Cancer 1981;44:618‐27.

Chlebowski 2009

Chlebowski RT, Kuller LH, Prentice RL, Stefanick ML, Manson JE, Gass M, et al. Breast cancer after use of estrogen plus progestin in postmenopausal women. New England Journal of Medicine 2009;360:573‐87.

Christiansen 2000

Christiansen CL, Wang F, Barton MB, Kreuter W, Elmore JG, Gelfand AE, Fletcher SW. Predicting the cumulative risk of false‐positive mammograms. Journal of the National Cancer Institute 2000;92:1657‐66.

Cox 1997

Cox B. Variation in the effectiveness of breast screening by year of follow‐up. Journal of the National Cancer Institute. Monographs 1997;22:69‐72.

Crewdson 2002

Crewdson J. Swedes doubt mammography trial: disparities found in landmark study. Chicago Tribune 2002;March 15:http://www.chicagotribune.com/news/chi‐0203150264mar15.story (accessed 15 March, 2002).

Dean 2010

Dean P, Tabár L. Why does vehement opposition to screening come from Denmark, which has one of Europes highest breast cancer mortality rates?. BMJ 2010:http://www.bmj.com/content/340/bmj.c1241.full/reply#bmj_el_234798.

Deeks 2003

Deeks JJ, Dinnes J, D'Amico R, Sowden AJ, Sakarovitch C, Song F, Petticrew M, Altman DG, International Stroke Trial Collaborative Group, European Carotid Surgery Trial Collaborative Group. Evaluating non‐randomised intervention studies. Health Technology Assessment (Winchester, England) 2003;7(27):1‐173.

Demissie 1998

Demissie K, Mills OF, Rhoads GG. Empirical comparison of the results of randomized controlled trials and case‐control studies in evaluating the effectiveness of screening mammography. Journal of Clinical Epidemiology 1998;52:81‐91.

Dixon 2009

Dixon JM. Breast screening has increased the number of mastectomies. Breast Cancer Research 2009;11(Suppl 3):S19.

Dixon‐Woods 2001

Dixon‐Woods M, Baum M, Kurinczuk JJ. Screening for breast cancer with mammography. The Lancet 2001;358:2167‐8.

Doll 1981

Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. Journal of the National Cancer Institute 1981;66:1191‐308.

Domenighetti 2003

Domenighetti G, D'Avanzo B, Egger M, Berrino F, Perneger T, Mosconi P, et al. Women's perception of the benefits of mammography screening: population‐based survey in four countries. International Journal of Epidemiology 2003;32:816‐21.

Douek 2003

Douek M, Baum M. Mass breast screening: is there a hidden cost?. The British Journal of Surgery 2003;90 Suppl 1:(Abstract Breast 14).

Duffy 2002

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Tabar L, Fagerberg CJ, Gad A, Baldetorp L, Holmberg LH, Grontoft O, et al. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet 1985;1(8433):829‐32.

Tabar 1985a

Tabar L, Gad A, Holmberg L, Ljungquist U. Significant reduction in advanced breast cancer. Results of the first seven years of mammography screening in Kopparberg, Sweden. Diagnostic Imaging in Clinical Medicine 1985;54(3‐4):158‐64.

Tabar 1988

Tabar L, Fagerberg CJG, Day NE. The results of periodic one‐view mammographic screening in Sweden. Part 2: Evaluation of the results. In: Day NE, Miller AB editor(s). Screening for breast cancer. Toronto: Hans Huber, 1988:39‐44.

Tabar 1989

Tabar L, Fagerberg G, Duffy SW, Day NE. The Swedish two county trial of mammographic screening for breast cancer: recent results and calculation of benefit. Journal of Epidemiology and Community Health 1989;43(2):107‐14.

Tabar 1990

Tabar L, Duffy SW, Day NE. Screening with mammography [letter]. International Journal of Technology Assessment in Health Care 1990;6(3):498‐500.

Tabar 1991

Tabar L, Fagerberg CJG, South MC, Day NE, Duffy SW. The Swedish Two‐county Trial of mammographic screening for breast cancer: recent results on mortality and tumour characteristics. In: Miller AB, Chamberlain J, Day NE, et al. editor(s). Cancer screening. Cambridge: Cambridge University Press, 1991:23‐36.

Tabar 1992

Tabar L, Fagerberg G, Duffy SW, Day NE, Gad A, Grontoft O. Update of the Swedish two‐county program of mammographic screening for breast cancer. Radiologic Clinics of North America 1992;30(1):187‐210.

Tabar 1995

Tabar L, Fagerberg G, Chen HH, Duffy SW, Smart CR, Gad A, et al. Efficacy of breast cancer screening by age. New results from the Swedish Two‐County Trial. Cancer 1995;75(10):2507‐17.

Tabar 1996

Tabar L, Fagerberg G, Chen HH, Duffy SW, Gad A. Tumour development, histology and grade of breast cancers: prognosis and progression. International Journal of Cancer 1996;66:413‐9.

Tabar 1999

Tabar L, Chen HH, Duffy SW, Krusemo UB. Primary and adjuvant therapy, prognostic factors and survival in 1053 breast cancers diagnosed in a trial of mammography screening. Japanese Journal of Clinical Oncology 1999;29(12):608‐16.

Tabar 2000

Tabar L, Vitak B, Chen HH, et al. The Swedish Two‐County Trial twenty years later. Updated mortality results and new insights from long‐term follow‐up. Radiologic Clinics of North America 2000;38(4):625‐51.

Tabar 2000a

Tabar L. Personal communication 17 Jan 2000.

Tabar 2001

Tabar L, Vitak B, Chen HH, Yen MF, Duffy SW, Smith RA. Beyond randomized controlled trials: organized mammographic screening substantially reduces breast carcinoma mortality. Cancer 2001;91(9):1724‐31.

Tabar 2002

Tabár L, Smith RA, Duffy SW. Update on effects of screening mammography. Lancet 2002;360:337.

Tabar 2002a

Tabar L, Duffy SW, Yen MF, Warwick J, Vitak B, Chen HH, et al. All‐cause mortality among breast cancer patients in a screening trial: support for breast cancer mortality as an end point. Journal of Medical Screening 2002;9(4):159‐62.

Tabar 2003

Tabar L, Smith RA, Vitak B, Yen MF, Chen TH, Warwick J, et al. Mammographic screening: a key factor in the control of breast cancer. Cancer Journal 2003;9(1):15‐27.

Tabar 2003a

Tabar L, Yen MF, Vitak B, Chen HH, Smith RA, Duffy SW. Mammography service screening and mortality in breast cancer patients: 20‐year follow‐up before and after introduction of screening. Lancet 2003;361:1405‐10.

The Lancet Erratum 2002

The Lancet Erratum. Department of error: update on screening mammography. The Lancet2002; Vol. 360, issue 9340:1178.

Thomas 1977

Thomas LB, Ackerman LV, McDivitt RW, Hanson TAS, Hankey BF, Prorok PC. Report of NCI ad hoc pathology working group to review the gross and microscopic findings of breast cancer cases in the HIP study. Journal of the National Cancer Institute 1977;59(2):496‐541.

Thornton 1997

Thornton H. The voice of the breast cancer patient ‐ a lonely cry in the wilderness. European Journal of Cancer 1997;33(6):825‐8.

UK review 2012

Independent UK Panel on Breast Cancer Screening. The benefits and harms of breast cancer screening: an independent review. Lancet 2010;380:1778‐86.

US Task Force 2002

US Preventive Services Task Force. Screening for breast cancer: recommendations and rationale. Annals of Internal Medicine 2002;137(5 Part 1):344‐6.

Wald 1993

Wald NJ, Chamberlain J, Hackshaw A. Report of the European Society for Mastology Breast Cancer Screening Evaluation Committee (1993). Breast 1993;2:209‐16.

Walter 1999

Walter SD, Jadad AR. Meta‐analysis of screening data: a survey of the literature. Statistics in Medicine 1999;18(24):3409‐24.

Welch 1997

Welch HG, Black WC. Using autopsy series to estimate the disease reservoir for ductal carcinoma in situ of the breast. Annals of Internal Medicine 1997;127:1023‐8.

Welch 2006

Welch HG. How much overdiagnosis?. BMJ 2006 Mar 10:http://www.bmj.com/content/332/7543/689?tab=responses (accessed 21 Dec 2012).

Werkö 1995

Werkö L. Mammografi, vinst och risk. Läkartidningen 1995;92:4540.

Westerholm 1988

Westerholm B. Stötande syn på medelålders kvinnors värde. Läkartidningen 1988;85(47):4056‐7.

Zahl 2001

Zahl P‐H, Kopjar B, Mæhlen J. Norwegian breast cancer mortality rates and validity in Swedish mammography trials. Tidsskrift for den Norske Lægeforening 2001;121:1928‐31.

Zahl 2004

Zahl PH, Strand BH, Maehlen J. Incidence of breast cancer in Norway and Sweden during introduction of nationwide screening: prospective cohort study. BMJ 2004;328:921‐4.

Zahl 2006

Zahl P‐H, Gøtzsche PC, Andersen JM, Mæhlen J. Results of the Two‐County trial of mammography screening are not compatible with contemporaneous official Swedish breast cancer statistics. Danish Medical Bulletin 2006;53:438‐40.

Zahl 2008

Zahl PH, Mæhlen J, Welch HG. The natural history of breast cancers detected by screening mammography. Archives of Internal Medicine 2008;168:2311‐6.

Zahl 2011

Zahl PH, Gøtzsche PC, Mæhlen J. Natural history of breast cancers detected in the Swedish mammography screening programme: a cohort study. Lancet Oncology 2011;12(12):1118‐24.

References to other published versions of this review

Ir a:

Gøtzsche 2006

Gøtzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database of Systematic Reviews 2006, Issue 4. [DOI: 10.1002/14651858.CD001877]

Gøtzsche 2009a

Gøtzsche PC, Nielsen M. Screening for breast cancer with mammography. Cochrane Database of Systematic Reviews 2009, Issue 4. [DOI: 10.1002/14651858.CD001877]

Olsen 2001

Olsen O, Gøtzsche PC. Screening for breast cancer with mammography. Cochrane Database of Systematic Reviews 2001, Issue 4. [DOI: 10.1002/14651858.CD001877]

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

Canada 1980

Methods

Individual randomisation in blocks of 2 or 4, stratified by centre and 5‐year age group (see also text).

Cause of death was assessed blinded and independently by two specialists for women with diagnosed breast cancer and for other possible breast cancer deaths.

Participants

Women aged 40‐59 years.

Number randomised: see below.

Interventions

Two‐view mammography: cranio‐caudal and mediolateral (later medio‐lateral oblique except in two centres).

4‐5 cycles of screening with yearly interval.

Outcomes

Total mortality.
Breast cancer mortality.
Surgical interventions.

Notes

Attendance rate: 100% in first round.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer‐generated block randomization with two block sizes (equalled out the allocations only after every 48 entries; Baines, personal information, June 2011).

Allocation concealment (selection bias)

Low risk

Adequate, see text.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Not possible for a screening trial and not relevant.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

Cause of death was assessed blinded.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Very few women excluded after randomisation (see text) and none because of previous breast cancer.

Selective reporting (reporting bias)

Low risk

This trial has been meticulously reported and documented.

Other bias

Low risk
Canada 1980a

Methods

See Canada 1980.

Participants

Women aged 40‐49 years.

50,472 randomised.

59 were excluded from analyses, distributed equally between the two groups.

Interventions

See Canada 1980.

Screened women had an annual clinical examination while control women were examined at the first visit and were taught self‐examination at that visit and were reminded annually by mail.

Outcomes

See Canada 1980.

Notes

Attendance rate: 100% in first round, 89% in second, decreasing to 86% in fifth round.

Mammography in control group: 26%, most only once during the trial.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

See Canada 1980.

Allocation concealment (selection bias)

Low risk

See Canada 1980.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

See Canada 1980.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

See Canada 1980.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

See Canada 1980.

Selective reporting (reporting bias)

Low risk

See Canada 1980.

Other bias

Low risk

See Canada 1980.
Canada 1980b

Methods

See Canada 1980.

Participants

Women aged 50‐59 years.

39,459 randomised.

54 were excluded from analyses, distributed equally between the two groups.

Interventions

See Canada 1980.

All women had their breasts examined annually.

Outcomes

See Canada 1980.

Notes

Attendance rate: 100% in first round, 90% in second, decreasing to 87% in fifth round.

Mammography in control group: 17%.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

See Canada 1980.

Allocation concealment (selection bias)

Low risk

See Canada 1980.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

See Canada 1980.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

See Canada 1980.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

See Canada 1980.

Selective reporting (reporting bias)

Low risk

See Canada 1980.

Other bias

Low risk

See Canada 1980.
Edinburgh 1978

Methods

Stratified cluster randomisation; general practices were clusters; stratification was by size of practice. About 87 clusters (numbers vary in different reports, see text).

Blinding of outcome assessment not stated.

Participants

Women aged 45‐64 years.

Number of women and practices randomised inconsistently reported (see text).

Very biased exclusions occurred: exclusion procedures different in study and control group, 177 previous breast cancer cases excluded from control group and 338 from study group.

Interventions

Two‐view mammography at first screen: cranio‐caudal and oblique (except in one practice); only oblique in later rounds.

Screened group: mammography and physical examination year 1, 3, 5 and 7; physical examination year 2, 4 and 6.

Control group: usual care.

Outcomes

Total mortality.
Breast cancer mortality.
Radiotherapy.

Notes

Attendance rate: Circa 60% in first round; 44% in seventh round.

Mammography in control group: unknown.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

High risk

No information, but some clusters later changed allocation status.

Allocation concealment (selection bias)

High risk

The randomisation failed to an important degree to create comparable groups.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Not possible for a screening trial and not relevant.

Blinding of outcome assessment (detection bias)
All outcomes

High risk

Not stated.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Not relevant, as randomisation failed to create comparable groups.

Selective reporting (reporting bias)

Unclear risk

Not relevant, as randomisation failed to create comparable groups.

Other bias

High risk

Not relevant, as randomisation failed to create comparable groups.
Göteborg 1982

Methods

See Göteborg 1982a and 1982b.

Participants

Women aged 39‐59 years.

Number of women randomised: 21,904 to screening, 30,318 to control (see also text).

254 women (1.2%) excluded from the screening group and 357 (1.2%) from the control group due to a history of breast carcinoma prior to randomisation.

Interventions

See Göteborg 1982a and 1982b.

Outcomes

Total mortality.
Breast cancer mortality.

Notes

Mammography in control group: 18% during last two years.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

High risk

Day of birth used. Randomisation ratios varied, not clear whether this was taken into account in the analysis.

Allocation concealment (selection bias)

High risk

Day of birth.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Not possible for a screening trial and not relevant.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

Blinding of outcome assessment.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Women with previous breast cancer were excluded after randomisation.

Selective reporting (reporting bias)

Low risk

We found no evidence for this.

Other bias

High risk

The whole control group was invited to screening when the trial ended, which renders follow‐up data unreliable.

Göteborg 1982a

Methods

Individual randomisation within year of birth cohort ‐ by day of birth in the cohorts 1923‐1935 and by computer software for the cohorts 1936‐1944 ‐ randomisation ratio varied by cohort, on average approximately 1:1.2 (see also text).

Blinding of outcome assessment.

Participants

Women aged 39‐49 years.

Number of women randomised: 11,792 to screening, 14,321 to control (see also text).

68 women (0.6%) excluded from the screening group and 104 (0.7%) from the control group due to a history of breast carcinoma prior to randomisation.

Interventions

Two‐view mammography at first screen, single at later rounds ‐ single read at first three rounds; double read thereafter.

5 cycles with an interval of 18 months.

Control group: usual care.

Outcomes

Total mortality.
Breast cancer mortality.

Notes

Attendance rate: 85%, 78%, 79%, 77%, 75% in rounds 1‐5.
66% at first screen in control group.
Mammography in control group: 19% during last two years; 51% ever.
Early systematic screening of control group.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

See Göteborg 1982.

Allocation concealment (selection bias)

Unclear risk

See Göteborg 1982.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

See Göteborg 1982.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

See Göteborg 1982.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

See Göteborg 1982.

Selective reporting (reporting bias)

Low risk

See Göteborg 1982.

Other bias

High risk

See Göteborg 1982.
Göteborg 1982b

Methods

Individual randomisation by computer software ‐ randomisation ratio varied by cohort, on average approximately 1:1.6.

Blinding of outcome assessment.

Participants

Women aged 50‐59 years.

Number of women randomised not stated explicitly, but can be calculated by comparing two trial reports (see Göteborg 1992 above for total numbers).

Interventions

Two‐view mammography at first screen, single at later rounds ‐ single read at first three rounds; double read thereafter.

4 cycles with an interval of 18 months.

Control group: usual care.

Outcomes

Total mortality.
Breast cancer mortality.

Notes

Attendance rate: 83% at first screen.
78% at first screen in control group.
Early systematic screening of control group.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

See Göteborg 1982.

Allocation concealment (selection bias)

Unclear risk

See Göteborg 1982.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

See Göteborg 1982.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

See Göteborg 1982.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

See Göteborg 1982.

Selective reporting (reporting bias)

Low risk

See Göteborg 1982.

Other bias

High risk

See Göteborg 1982.
Kopparberg 1977

Methods

Stratified cluster randomisation; seven blocks each contained 3 units (in three blocks the units were parishes and in four municipalities); randomisation ratio 2:1 (see also text).

Blinding of outcome assessment not stated.

Participants

Women aged 40 years and above.

21 units randomised: 47,389 women in screening areas and 22,658 in control areas (33,641 vs. 16,359 in age group 40‐69 years; 39,051 versus 18,846 in age group 40‐74 years).

No parishes or municipalities excluded. Exclusion criteria for patients unclear but probably biased (see text).

Interventions

One‐view mammography, mediolateral oblique; additional views on suspicion.

Number of screenings: two cycles prestated, but more may have occurred (see text).
Interval between screens were 2 years for women aged 40‐49 years; 3 years for women aged 50 years and above.

Outcomes

Total mortality.
Breast cancer mortality.
Surgical interventions.
Chemotherapy.
Radiotherapy.

Notes

Attendance rate: 91‐94% for women younger than 60 years; 50‐80% for women above 60 years.

Unclear when screening started in control group (see text).

Early systematic screening of control group.

Mammography in control group: 13%.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

See Two‐County 1977.

Allocation concealment (selection bias)

High risk

See Two‐County 1977.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

See Two‐County 1977.

Blinding of outcome assessment (detection bias)
All outcomes

High risk

See Two‐County 1977.

Incomplete outcome data (attrition bias)
All outcomes

High risk

See Two‐County 1977.

Selective reporting (reporting bias)

High risk

See Two‐County 1977.

Other bias

High risk

See Two‐County 1977.
Malmö 1976

Methods

Individual randomisation; within each birth cohort a computer list was randomised and the first half invited for screening.

Blinding of outcome assessment: deaths among breast cancer cases assessed blinded and independently by a pathologist and an oncologist; discrepancies resolved by an internist.

Participants

Women aged 45‐69 years.

21,242 randomised into screened group; 21,240 or 21,244 into control group (see text).

Biased exclusions seem to have occurred: 154 women excluded from control group, 49 from study group (see text).

Interventions

One‐view or two‐view mammography; two‐view in 1st and 2nd round; one‐view or two‐view in later rounds depending on parenchymal pattern.

5‐6 cycles according to protocol; 8 cycles in 1988; more during 1988‐1992.

Interval between screens: 18‐24 months.

Control group: usual care.

Outcomes

Total mortality.
Breast cancer mortality.
Surgical interventions.
Chemotherapy.
Radiotherapy.

Notes

Attendance rate: Circa 70%; 74% in first round ranging from 64% in oldest age group to 79% in youngest.

Mammography in control group: screening offered to age group 50‐69 years in 1991; invited in 1992 and completed in 1993.

6% had more than 3 mammograms during study; 24% had one or more; 35% among women aged 45‐49 years at entry.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer.

Allocation concealment (selection bias)

Low risk

Done by a computer on one occasion for the whole sample.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Not possible for a screening trial and not relevant.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

Blinding of outcome assessment.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Very few women missing.

Selective reporting (reporting bias)

Low risk

This trial has been meticulously reported and documented.

Other bias

Low risk
Malmö II 1978

Methods

See text of the review; extension of Malmö 1976.

Participants

Interventions

Outcomes

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

High risk

See text of the review; extension of Malmö 1976, not done according to a formal protocol, inclusion criteria violated, group sizes differed although they should have been the same, and gross and unexplained imbalance in numbers in the two groups.

Allocation concealment (selection bias)

High risk

See 'Random sequence generation.'

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Not possible for a screening trial and not relevant.

Blinding of outcome assessment (detection bias)
All outcomes

High risk

See 'Random sequence generation.'

Incomplete outcome data (attrition bias)
All outcomes

High risk

See 'Random sequence generation.'

Selective reporting (reporting bias)

High risk

See 'Random sequence generation.'

Other bias

High risk

See 'Random sequence generation.'
New York 1963

Methods

Individual randomisation within matched pairs; pairs derived from a computer list sorted by age, family size and employment group.

A blinded review was carried out in a subsample of death certificates where cause of death was breast cancer. The panel much more often stated breast cancer as cause of death in the control group.

Participants

Women aged 40‐64 years.

Probably 31,092 pairs of women were randomised into screening and control group.

Very biased exclusions occurred: probably 336 previous breast cancer cases were excluded from the control group and 853 from study group (see text).

Interventions

Two view mammography: cephalocaudal and lateral.
4 cycles (three were planned according to the first publications).

Screened group: annual physical examinations.

Control group: usual care.

Outcomes

Total mortality.
Breast cancer mortality.
Surgical interventions.
Radiotherapy.

Notes

Attendance rate: 65% in total population, circa 58%, 50% and 40% participated in 2, 3 and 4 screens, respectively.

Mammography in control group: not described.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

High risk

Confusing information and the exact number of randomised women not stated.

Allocation concealment (selection bias)

Unclear risk

Unclear.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Not possible for a screening trial and not relevant.

Blinding of outcome assessment (detection bias)
All outcomes

High risk

A blinded review was carried out in a subsample of death certificates where cause of death was breast cancer. The panel much more often stated breast cancer as cause of death in the control group.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Confusing information and the exact number of randomised women not stated.

Selective reporting (reporting bias)

High risk

Confusing information and the exact number of randomised women not stated.

Other bias

High risk

Some women with previous breast cancer in the control group should have been excluded, which they all were in the screened group.

Stockholm 1981

Methods

Individual randomisation by day of birth; 1‐10 and 21‐31 in study group and 11‐20 in control group (see also text).

Blinding of outcome assessment: not stated.

Participants

Women aged 40‐64 years.

Number of women randomised inconsistently reported (see text).

Exclusions after randomisation unclear (see text).

Interventions

Single oblique mammography; recalled for conventional three‐view if malignancies suspected.

2 cycles (number not predetermined ‐ screening introduced in control group because of results from Kopparberg).

Interval between screens: Circa 2 years; 2.5 years to complete first round and 2.1 to complete second round.

Control group: usual care.

Outcomes

Total mortality.
Breast cancer mortality.
Surgical interventions.

Notes

Attendance rate: circa 80%.

Mammography in control group: 8% during one year; 25% in study group during two years previous to screening.

Early systematic screening of control group.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

High risk

Day of birth.

Allocation concealment (selection bias)

High risk

Day of birth.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Not possible for a screening trial and not relevant.

Blinding of outcome assessment (detection bias)
All outcomes

High risk

Blinding of outcome assessment not stated.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Reported numbers are inconsistent.

Selective reporting (reporting bias)

High risk

Reported numbers are inconsistent.

Other bias

High risk

Reported numbers are inconsistent.
Two‐County 1977

Methods

Stratified cluster randomisation (see Kopparberg 1977 and Östergötland 1978 for details).

Blinding of cause of death assessments in some later updates for use in Swedish meta‐analyses.

Participants

Women aged 40‐74 years.

(See Kopparberg 1977 and Östergötland 1978 for details).

Interventions

See Kopparberg 1977 and Östergötland 1978.

Screened women were encouraged to perform self‐examination of the breasts every month.

Control women: usual care.

Outcomes

See Kopparberg 1977 and Östergötland 1978.

Notes

See Kopparberg 1977 and Östergötland 1978.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

No information.

Allocation concealment (selection bias)

High risk

See text, information inconsistent and incomplete.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Not possible for a screening trial and not relevant.

Blinding of outcome assessment (detection bias)
All outcomes

High risk

Blinding of outcome assessment not stated.

Incomplete outcome data (attrition bias)
All outcomes

High risk

Numbers of women, cancers and deaths vary in the reports of the trial.

Selective reporting (reporting bias)

High risk

Numbers of women, cancers and deaths vary in the reports of the trial.

Other bias

High risk

Numbers of women, cancers and deaths vary in the reports of the trial, see also main text.

UK age trial 1991

Methods

Individual randomisation by computer; randomisation ratio 1:2.

Information on cause of death was obtained from the central register of the National Health Service.

Participants

Women aged 39‐41 years.

53,914 randomised into screened group; 107,007 into control group.

30 and 51 excluded after randomisation.

Interventions

Two‐view mammography at first screen, and by single mediolateral oblique view thereafter, with recall for full assessment if an abnormality was suspected.

7 annual screens planned.

Control group: usual care.

Outcomes

Total mortality.
Breast cancer mortality.

Notes

Number of cancers in latest report given per 1000 women‐years.

Participation rate: ca 66% at prevalence screen, below 50% at 8th screen.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Computer.

Allocation concealment (selection bias)

Low risk

Individual randomisation by computer.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

Not possible for a screening trial and not relevant.

Blinding of outcome assessment (detection bias)
All outcomes

Low risk

Information on cause of death was obtained from the central register of the National Health Service.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Very few women excluded after randomisation.

Selective reporting (reporting bias)

Low risk

We found no evidence for this

Other bias

Low risk

We found no evidence for this
Östergötland 1978

Methods

Stratified cluster randomisation; 12 blocks (consisting of 164 parishes in total) were each split into 2 units of roughly equal size and socio‐economic composition; randomisation ratio 1:1 (see also text).

Blinding of outcome assessment not stated.

Participants

Women aged 40 years and above.

24 units with 92,934 women randomised into 47,001 in screening parishes and 45,933 in control parishes (39,034 versus 37,936 in age group 40‐74 years).

No parishes or municipalities excluded.

Women with a previous history of breast cancer were excluded after randomisation; exclusions seem unbiased (see text).

Interventions

One‐view mammography, mediolateral oblique; women who reported a lump were examined clinically and by complete mammography.

2 screens for women above 70 years, 3 for women originally in age group 40‐69 years.

Interval between screens: 2‐2.5 years.

Outcomes

Total mortality.
Breast cancer mortality.

Notes

Attendance rate: ca. 90% in first round, 80% in second, very age dependent.

Mammography in control group: 13%.

Early systematic screening of control group.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

See Two‐County 1977.

Allocation concealment (selection bias)

High risk

See Two‐County 1977.

Blinding of participants and personnel (performance bias)
All outcomes

Low risk

See Two‐County 1977.

Blinding of outcome assessment (detection bias)
All outcomes

High risk

See Two‐County 1977.

Incomplete outcome data (attrition bias)
All outcomes

High risk

See Two‐County 1977.

Selective reporting (reporting bias)

High risk

See Two‐County 1977.

Other bias

High risk

See Two‐County 1977.

Characteristics of excluded studies [ordered by study ID]

Ir a:

Study

Reason for exclusion

Berglund 2000

Multiple risk factor intervention study, with several interventions, including mammography, not a randomised trial but alternating allocation of birth year cohorts with resulting age differences at baseline between the two groups; 50 women died from cancer of 8,712 participants, no data on breast cancer.

Dales 1979

Multiple risk factor intervention trial, with several interventions, regular mammography was only one of the interventions and only about 1000 women were invited for mammography.

Singapore 1994

Singapore Breast Screening Project. Randomised 166,600 women aged 50‐64 years, but the only intervention was the prevalence screen, and exclusions after randomisation occurred only in the screened group. Previous cancer at any site was an exclusion criterion; more than 1500 women were excluded from the screened group, 468 because they were already dead.

Data and analyses

Open in table viewer
Comparison 1. Screening with mammography versus no screening

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Deaths ascribed to breast cancer, 7 years follow up Show forest plot

11

616327

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.72, 0.90]
Analysis 1.1
Comparison 1 Screening with mammography versus no screening, Outcome 1 Deaths ascribed to breast cancer, 7 years follow up.

Comparison 1 Screening with mammography versus no screening, Outcome 1 Deaths ascribed to breast cancer, 7 years follow up.

1.1 Adequately randomised trials

4

292958

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.79, 1.09]

1.2 Suboptimally randomised trials

7

323369

Risk Ratio (M‐H, Fixed, 95% CI)

0.71 [0.61, 0.83]

2 Deaths ascribed to breast cancer, 13 years follow up Show forest plot

9

599090

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.74, 0.87]
Analysis 1.2
Comparison 1 Screening with mammography versus no screening, Outcome 2 Deaths ascribed to breast cancer, 13 years follow up.

Comparison 1 Screening with mammography versus no screening, Outcome 2 Deaths ascribed to breast cancer, 13 years follow up.

2.1 Adequately randomised trials

4

292153

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.79, 1.02]

2.2 Suboptimally randomised trials

5

306937

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.67, 0.83]

3 Deaths ascribed to breast cancer, 7 years follow up, women below 50 years of age (Malmö 55) Show forest plot

9

356368

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.77, 1.04]
Analysis 1.3
Comparison 1 Screening with mammography versus no screening, Outcome 3 Deaths ascribed to breast cancer, 7 years follow up, women below 50 years of age (Malmö 55).

Comparison 1 Screening with mammography versus no screening, Outcome 3 Deaths ascribed to breast cancer, 7 years follow up, women below 50 years of age (Malmö 55).

3.1 Adequately randomised trials

3

227333

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.78, 1.14]

3.2 Suboptimally randomised trials

6

129035

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.63, 1.05]

4 Deaths ascribed to breast cancer, 7 years follow up, women at least 50 years of age (Malmö 55) Show forest plot

7

261044

Risk Ratio (M‐H, Fixed, 95% CI)

0.72 [0.62, 0.85]
Analysis 1.4
Comparison 1 Screening with mammography versus no screening, Outcome 4 Deaths ascribed to breast cancer, 7 years follow up, women at least 50 years of age (Malmö 55).

Comparison 1 Screening with mammography versus no screening, Outcome 4 Deaths ascribed to breast cancer, 7 years follow up, women at least 50 years of age (Malmö 55).

4.1 Adequately randomised trials

2

65625

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.64, 1.20]

4.2 Suboptimally randomised trials

5

195419

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.56, 0.81]

5 Deaths ascribed to breast cancer, 13 years follow up, women below 50 years of age Show forest plot

8

329511

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.73, 0.96]
Analysis 1.5
Comparison 1 Screening with mammography versus no screening, Outcome 5 Deaths ascribed to breast cancer, 13 years follow up, women below 50 years of age.

Comparison 1 Screening with mammography versus no screening, Outcome 5 Deaths ascribed to breast cancer, 13 years follow up, women below 50 years of age.

5.1 Adequately randomised trials

3

218697

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.73, 1.03]

5.2 Suboptimally randomised trials

5

110814

Risk Ratio (M‐H, Fixed, 95% CI)

0.80 [0.64, 0.98]

6 Deaths ascribed to breast cancer, 13 years follow up, women at least 50 years of age Show forest plot

7

268874

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.69, 0.86]
Analysis 1.6
Comparison 1 Screening with mammography versus no screening, Outcome 6 Deaths ascribed to breast cancer, 13 years follow up, women at least 50 years of age.

Comparison 1 Screening with mammography versus no screening, Outcome 6 Deaths ascribed to breast cancer, 13 years follow up, women at least 50 years of age.

6.1 Adequately randomised trials

2

74261

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.77, 1.15]

6.2 Suboptimally randomised trials

5

194613

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.62, 0.80]

7 Deaths ascribed to any cancer, all women Show forest plot

6

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 1.7
Comparison 1 Screening with mammography versus no screening, Outcome 7 Deaths ascribed to any cancer, all women.

Comparison 1 Screening with mammography versus no screening, Outcome 7 Deaths ascribed to any cancer, all women.

7.1 Adequately randomised trials

3

132118

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.95, 1.10]

7.2 Suboptimally randomised trials (unreliable estimates)

3

195871

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.93, 1.06]

8 Overall mortality, 7 years follow up Show forest plot

11

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 1.8
Comparison 1 Screening with mammography versus no screening, Outcome 8 Overall mortality, 7 years follow up.

Comparison 1 Screening with mammography versus no screening, Outcome 8 Overall mortality, 7 years follow up.

8.1 Adequately randomised trials

4

292958

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.94, 1.03]

8.2 Suboptimally randomised trials (unreliable estimates)

7

324977

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.96, 1.02]

9 Overall mortality, 13 years follow up Show forest plot

8

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 1.9
Comparison 1 Screening with mammography versus no screening, Outcome 9 Overall mortality, 13 years follow up.

Comparison 1 Screening with mammography versus no screening, Outcome 9 Overall mortality, 13 years follow up.

9.1 Adequately randomised trials

4

292958

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.95, 1.03]

9.2 Suboptimally randomised trials (unreliable estimates)

4

244868

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.97, 1.01]

10 Overall mortality, 7 years follow up, women below 50 years of age Show forest plot

7

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 1.10
Comparison 1 Screening with mammography versus no screening, Outcome 10 Overall mortality, 7 years follow up, women below 50 years of age.

Comparison 1 Screening with mammography versus no screening, Outcome 10 Overall mortality, 7 years follow up, women below 50 years of age.

10.1 Adequately randomised trials

2

211270

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.90, 1.04]

10.2 Suboptimally randomised trials (unreliable estimates)

5

99656

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.98, 1.16]

11 Overall mortality, 7 years follow up, women at least 50 years of age Show forest plot

5

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 1.11
Comparison 1 Screening with mammography versus no screening, Outcome 11 Overall mortality, 7 years follow up, women at least 50 years of age.

Comparison 1 Screening with mammography versus no screening, Outcome 11 Overall mortality, 7 years follow up, women at least 50 years of age.

11.1 Adequately randomised trials

1

39405

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.85, 1.20]

11.2 Suboptimally randomised trials (unreliable estimates)

4

161519

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.94, 1.00]

12 Overall mortality, 13 years follow up, women below 50 years of age Show forest plot

6

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 1.12
Comparison 1 Screening with mammography versus no screening, Outcome 12 Overall mortality, 13 years follow up, women below 50 years of age.

Comparison 1 Screening with mammography versus no screening, Outcome 12 Overall mortality, 13 years follow up, women below 50 years of age.

12.1 Adequately randomised trials

3

219324

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.92, 1.04]

12.2 Suboptimally randomised trials (unreliable estimates)

3

61344

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.92, 1.10]

13 Overall mortality, 13 years follow up, women at least 50 years of age Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 1.13
Comparison 1 Screening with mammography versus no screening, Outcome 13 Overall mortality, 13 years follow up, women at least 50 years of age.

Comparison 1 Screening with mammography versus no screening, Outcome 13 Overall mortality, 13 years follow up, women at least 50 years of age.

13.1 Adequately randomised trials

2

73634

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.95, 1.04]

13.2 Suboptimally randomised trials (unreliable estimates)

2

98261

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.97, 1.02]

14 Number of mastectomies and lumpectomies Show forest plot

5

250479

Risk Ratio (M‐H, Fixed, 95% CI)

1.35 [1.26, 1.44]
Analysis 1.14
Comparison 1 Screening with mammography versus no screening, Outcome 14 Number of mastectomies and lumpectomies.

Comparison 1 Screening with mammography versus no screening, Outcome 14 Number of mastectomies and lumpectomies.

14.1 Adequately randomised trials

3

132321

Risk Ratio (M‐H, Fixed, 95% CI)

1.31 [1.22, 1.42]

14.2 Suboptimally randomised trials

2

118158

Risk Ratio (M‐H, Fixed, 95% CI)

1.42 [1.26, 1.61]

15 Number of mastectomies Show forest plot

5

250479

Risk Ratio (M‐H, Fixed, 95% CI)

1.20 [1.11, 1.30]
Analysis 1.15
Comparison 1 Screening with mammography versus no screening, Outcome 15 Number of mastectomies.

Comparison 1 Screening with mammography versus no screening, Outcome 15 Number of mastectomies.

15.1 Adequately randomised trials

3

132321

Risk Ratio (M‐H, Fixed, 95% CI)

1.20 [1.08, 1.32]

15.2 Suboptimally randomised trials

2

118158

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [1.06, 1.38]

16 Number treated with radiotherapy Show forest plot

2

100383

Risk Ratio (M‐H, Fixed, 95% CI)

1.32 [1.16, 1.50]
Analysis 1.16
Comparison 1 Screening with mammography versus no screening, Outcome 16 Number treated with radiotherapy.

Comparison 1 Screening with mammography versus no screening, Outcome 16 Number treated with radiotherapy.

16.1 Adequately randomised trials

1

42486

Risk Ratio (M‐H, Fixed, 95% CI)

1.24 [1.04, 1.49]

16.2 Suboptimally randomised trials

1

57897

Risk Ratio (M‐H, Fixed, 95% CI)

1.40 [1.17, 1.69]

17 Number treated with chemotherapy Show forest plot

2

100383

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.78, 1.19]
Analysis 1.17
Comparison 1 Screening with mammography versus no screening, Outcome 17 Number treated with chemotherapy.

Comparison 1 Screening with mammography versus no screening, Outcome 17 Number treated with chemotherapy.

17.1 Adequately randomised trials

1

42486

Risk Ratio (M‐H, Fixed, 95% CI)

0.63 [0.39, 1.04]

17.2 Suboptimally randomised trials

1

57897

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [0.84, 1.34]

18 Number treated with hormone therapy Show forest plot

2

100383

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.55, 0.96]
Analysis 1.18
Comparison 1 Screening with mammography versus no screening, Outcome 18 Number treated with hormone therapy.

Comparison 1 Screening with mammography versus no screening, Outcome 18 Number treated with hormone therapy.

18.1 Adequately randomised trials

1

42486

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.60, 1.08]

18.2 Suboptimally randomised trials

1

57897

Risk Ratio (M‐H, Fixed, 95% CI)

0.30 [0.12, 0.72]

19 Mortality among breast cancer patients in the Two‐County study, 7 years follow up Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 1.19
Comparison 1 Screening with mammography versus no screening, Outcome 19 Mortality among breast cancer patients in the Two‐County study, 7 years follow up.

Comparison 1 Screening with mammography versus no screening, Outcome 19 Mortality among breast cancer patients in the Two‐County study, 7 years follow up.

19.1 Mortality from cancers other than breast cancer

2

2063

Risk Ratio (M‐H, Fixed, 95% CI)

2.42 [1.00, 5.85]

19.2 Mortality from causes other than breast cancer

2

2063

Risk Ratio (M‐H, Fixed, 95% CI)

1.37 [0.93, 2.04]

20 Results for biased trial Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Analysis 1.20
Comparison 1 Screening with mammography versus no screening, Outcome 20 Results for biased trial.

Comparison 1 Screening with mammography versus no screening, Outcome 20 Results for biased trial.

20.1 Deaths ascribed to breast cancer, 7 years follow up

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.2 Deaths ascribed to breast cancer, 13 years follow up

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.3 Deaths ascribed to breast cancer, 7 years follow up, younger women (below 50 years of age)

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.4 Deaths ascribed to breast cancer, 7 years follow up, elderly women (at least 50 years of age)

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.5 Deaths ascribed to breast cancer, 13 years follow up, younger women (below 50 years of age)

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.6 Deaths ascribed to breast cancer, 13 years follow up, elderly women (at least 50 years of age)

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.7 Overall mortality, 7 years follow up

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.8 Number treated with radiotherapy

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

21 Number of cancers Show forest plot

7

512246

Risk Ratio (M‐H, Fixed, 95% CI)

1.29 [1.23, 1.35]
Analysis 1.21
Comparison 1 Screening with mammography versus no screening, Outcome 21 Number of cancers.

Comparison 1 Screening with mammography versus no screening, Outcome 21 Number of cancers.

21.1 Adequately randomised trials (after 7‐9 years)

4

292979

Risk Ratio (M‐H, Fixed, 95% CI)

1.25 [1.18, 1.34]

21.2 Suboptimally randomised trials (before control group screen)

3

219267

Risk Ratio (M‐H, Fixed, 95% CI)

1.33 [1.24, 1.44]

Comparison 1 Screening with mammography versus no screening, Outcome 1 Deaths ascribed to breast cancer, 7 years follow up.
Figuras y tablas -
Analysis 1.1

Comparison 1 Screening with mammography versus no screening, Outcome 1 Deaths ascribed to breast cancer, 7 years follow up.

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Comparison 1 Screening with mammography versus no screening, Outcome 2 Deaths ascribed to breast cancer, 13 years follow up.
Figuras y tablas -
Analysis 1.2

Comparison 1 Screening with mammography versus no screening, Outcome 2 Deaths ascribed to breast cancer, 13 years follow up.

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Comparison 1 Screening with mammography versus no screening, Outcome 3 Deaths ascribed to breast cancer, 7 years follow up, women below 50 years of age (Malmö 55).
Figuras y tablas -
Analysis 1.3

Comparison 1 Screening with mammography versus no screening, Outcome 3 Deaths ascribed to breast cancer, 7 years follow up, women below 50 years of age (Malmö 55).

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Comparison 1 Screening with mammography versus no screening, Outcome 4 Deaths ascribed to breast cancer, 7 years follow up, women at least 50 years of age (Malmö 55).
Figuras y tablas -
Analysis 1.4

Comparison 1 Screening with mammography versus no screening, Outcome 4 Deaths ascribed to breast cancer, 7 years follow up, women at least 50 years of age (Malmö 55).

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Comparison 1 Screening with mammography versus no screening, Outcome 5 Deaths ascribed to breast cancer, 13 years follow up, women below 50 years of age.
Figuras y tablas -
Analysis 1.5

Comparison 1 Screening with mammography versus no screening, Outcome 5 Deaths ascribed to breast cancer, 13 years follow up, women below 50 years of age.

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Comparison 1 Screening with mammography versus no screening, Outcome 6 Deaths ascribed to breast cancer, 13 years follow up, women at least 50 years of age.
Figuras y tablas -
Analysis 1.6

Comparison 1 Screening with mammography versus no screening, Outcome 6 Deaths ascribed to breast cancer, 13 years follow up, women at least 50 years of age.

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Comparison 1 Screening with mammography versus no screening, Outcome 7 Deaths ascribed to any cancer, all women.
Figuras y tablas -
Analysis 1.7

Comparison 1 Screening with mammography versus no screening, Outcome 7 Deaths ascribed to any cancer, all women.

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Comparison 1 Screening with mammography versus no screening, Outcome 8 Overall mortality, 7 years follow up.
Figuras y tablas -
Analysis 1.8

Comparison 1 Screening with mammography versus no screening, Outcome 8 Overall mortality, 7 years follow up.

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Comparison 1 Screening with mammography versus no screening, Outcome 9 Overall mortality, 13 years follow up.
Figuras y tablas -
Analysis 1.9

Comparison 1 Screening with mammography versus no screening, Outcome 9 Overall mortality, 13 years follow up.

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Comparison 1 Screening with mammography versus no screening, Outcome 10 Overall mortality, 7 years follow up, women below 50 years of age.
Figuras y tablas -
Analysis 1.10

Comparison 1 Screening with mammography versus no screening, Outcome 10 Overall mortality, 7 years follow up, women below 50 years of age.

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Comparison 1 Screening with mammography versus no screening, Outcome 11 Overall mortality, 7 years follow up, women at least 50 years of age.
Figuras y tablas -
Analysis 1.11

Comparison 1 Screening with mammography versus no screening, Outcome 11 Overall mortality, 7 years follow up, women at least 50 years of age.

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Comparison 1 Screening with mammography versus no screening, Outcome 12 Overall mortality, 13 years follow up, women below 50 years of age.
Figuras y tablas -
Analysis 1.12

Comparison 1 Screening with mammography versus no screening, Outcome 12 Overall mortality, 13 years follow up, women below 50 years of age.

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Comparison 1 Screening with mammography versus no screening, Outcome 13 Overall mortality, 13 years follow up, women at least 50 years of age.
Figuras y tablas -
Analysis 1.13

Comparison 1 Screening with mammography versus no screening, Outcome 13 Overall mortality, 13 years follow up, women at least 50 years of age.

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Comparison 1 Screening with mammography versus no screening, Outcome 14 Number of mastectomies and lumpectomies.
Figuras y tablas -
Analysis 1.14

Comparison 1 Screening with mammography versus no screening, Outcome 14 Number of mastectomies and lumpectomies.

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Comparison 1 Screening with mammography versus no screening, Outcome 15 Number of mastectomies.
Figuras y tablas -
Analysis 1.15

Comparison 1 Screening with mammography versus no screening, Outcome 15 Number of mastectomies.

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Comparison 1 Screening with mammography versus no screening, Outcome 16 Number treated with radiotherapy.
Figuras y tablas -
Analysis 1.16

Comparison 1 Screening with mammography versus no screening, Outcome 16 Number treated with radiotherapy.

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Comparison 1 Screening with mammography versus no screening, Outcome 17 Number treated with chemotherapy.
Figuras y tablas -
Analysis 1.17

Comparison 1 Screening with mammography versus no screening, Outcome 17 Number treated with chemotherapy.

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Comparison 1 Screening with mammography versus no screening, Outcome 18 Number treated with hormone therapy.
Figuras y tablas -
Analysis 1.18

Comparison 1 Screening with mammography versus no screening, Outcome 18 Number treated with hormone therapy.

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Comparison 1 Screening with mammography versus no screening, Outcome 19 Mortality among breast cancer patients in the Two‐County study, 7 years follow up.
Figuras y tablas -
Analysis 1.19

Comparison 1 Screening with mammography versus no screening, Outcome 19 Mortality among breast cancer patients in the Two‐County study, 7 years follow up.

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Comparison 1 Screening with mammography versus no screening, Outcome 20 Results for biased trial.
Figuras y tablas -
Analysis 1.20

Comparison 1 Screening with mammography versus no screening, Outcome 20 Results for biased trial.

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Comparison 1 Screening with mammography versus no screening, Outcome 21 Number of cancers.
Figuras y tablas -
Analysis 1.21

Comparison 1 Screening with mammography versus no screening, Outcome 21 Number of cancers.

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Table 1. Examples of varying numbers of women in the Swedish trials

Study

Age range

Study group

Control group

Reference

Malmö

40‐74

21242

21240

Andersson 1980

40‐74

21242

21244

Andersson 1983

40‐74

21088

21195

Andersson 1988

Kopparberg

total

47389

22658

Socialstyrelsen 1985

40‐74

39051

18846

Tabar 1985

40‐74

38589

18582

Tabar 1989

40‐74

38562

18478

Nyström 1993

40‐74

38589

18582

Tabar 1995

40‐74

38568

18479

Nyström 2000

40‐74

38588

18582

Nixon 2000

40‐74

data not available

data not available

Nyström 2002

40‐49

9625

5053

Tabar 1988

40‐49

data not available

data not available

Nyström 1993a

40‐49

9582

5031

Tabar 1995

40‐49

9650

5009

Nyström 1997

Östergötland

total

47001

45933

Socialstyrelsen 1985

40‐74

39034

37936

Tabar 1985

40‐74

38491

37403

Tabar 1989

40‐74

38405

37145

Nyström 1993

40‐74

38491

37403

Tabar 1995

40‐74

38942

37675

Nyström 2000

40‐74

39105

37858

Nixon 2000

40‐74

38942

37675

Nyström 2002

40‐49

10312

10625

Tabar 1988

40‐49

data not available

data not available

Nyström 1993a

40‐49

10262

10573

Tabar 1995

40‐49

10240

10411

Nyström 1997

Stockholm

40‐64

40318

19943

Frisell 1989a

40‐65 (sic)

38525

20651

Nyström 1993

40‐64

40318

19943

Frisell 1997

40‐69

39139

20978

Nyström 2000

40‐49

data not available

data not available

Nyström 1993a

40‐49

14842

7103

Frisell 1997

40‐49

14185

7985

Nyström 1997

40‐49

14303

8021

Nyström 2002

Göteborg

40‐59

20724

28809

Nyström 1993

39‐59

21650

29961

Bjurstam 1997a

40‐59

21000

29200

Nyström 2000

40‐49

10821

13101

Nyström 1993a

39‐49

11724

14217

Bjurstam 1997

40‐49

10888

13203

Nyström 2002

Figuras y tablas -
Table 1. Examples of varying numbers of women in the Swedish trials
Ir a la tabla de la revisión
Comparison 1. Screening with mammography versus no screening

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Deaths ascribed to breast cancer, 7 years follow up Show forest plot

11

616327

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.72, 0.90]

1.1 Adequately randomised trials

4

292958

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.79, 1.09]

1.2 Suboptimally randomised trials

7

323369

Risk Ratio (M‐H, Fixed, 95% CI)

0.71 [0.61, 0.83]

2 Deaths ascribed to breast cancer, 13 years follow up Show forest plot

9

599090

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.74, 0.87]

2.1 Adequately randomised trials

4

292153

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.79, 1.02]

2.2 Suboptimally randomised trials

5

306937

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.67, 0.83]

3 Deaths ascribed to breast cancer, 7 years follow up, women below 50 years of age (Malmö 55) Show forest plot

9

356368

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.77, 1.04]

3.1 Adequately randomised trials

3

227333

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.78, 1.14]

3.2 Suboptimally randomised trials

6

129035

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.63, 1.05]

4 Deaths ascribed to breast cancer, 7 years follow up, women at least 50 years of age (Malmö 55) Show forest plot

7

261044

Risk Ratio (M‐H, Fixed, 95% CI)

0.72 [0.62, 0.85]

4.1 Adequately randomised trials

2

65625

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.64, 1.20]

4.2 Suboptimally randomised trials

5

195419

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.56, 0.81]

5 Deaths ascribed to breast cancer, 13 years follow up, women below 50 years of age Show forest plot

8

329511

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.73, 0.96]

5.1 Adequately randomised trials

3

218697

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.73, 1.03]

5.2 Suboptimally randomised trials

5

110814

Risk Ratio (M‐H, Fixed, 95% CI)

0.80 [0.64, 0.98]

6 Deaths ascribed to breast cancer, 13 years follow up, women at least 50 years of age Show forest plot

7

268874

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.69, 0.86]

6.1 Adequately randomised trials

2

74261

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.77, 1.15]

6.2 Suboptimally randomised trials

5

194613

Risk Ratio (M‐H, Fixed, 95% CI)

0.70 [0.62, 0.80]

7 Deaths ascribed to any cancer, all women Show forest plot

6

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 Adequately randomised trials

3

132118

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.95, 1.10]

7.2 Suboptimally randomised trials (unreliable estimates)

3

195871

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.93, 1.06]

8 Overall mortality, 7 years follow up Show forest plot

11

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

8.1 Adequately randomised trials

4

292958

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.94, 1.03]

8.2 Suboptimally randomised trials (unreliable estimates)

7

324977

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.96, 1.02]

9 Overall mortality, 13 years follow up Show forest plot

8

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 Adequately randomised trials

4

292958

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.95, 1.03]

9.2 Suboptimally randomised trials (unreliable estimates)

4

244868

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.97, 1.01]

10 Overall mortality, 7 years follow up, women below 50 years of age Show forest plot

7

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 Adequately randomised trials

2

211270

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.90, 1.04]

10.2 Suboptimally randomised trials (unreliable estimates)

5

99656

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.98, 1.16]

11 Overall mortality, 7 years follow up, women at least 50 years of age Show forest plot

5

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

11.1 Adequately randomised trials

1

39405

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.85, 1.20]

11.2 Suboptimally randomised trials (unreliable estimates)

4

161519

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.94, 1.00]

12 Overall mortality, 13 years follow up, women below 50 years of age Show forest plot

6

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

12.1 Adequately randomised trials

3

219324

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.92, 1.04]

12.2 Suboptimally randomised trials (unreliable estimates)

3

61344

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.92, 1.10]

13 Overall mortality, 13 years follow up, women at least 50 years of age Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

13.1 Adequately randomised trials

2

73634

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.95, 1.04]

13.2 Suboptimally randomised trials (unreliable estimates)

2

98261

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.97, 1.02]

14 Number of mastectomies and lumpectomies Show forest plot

5

250479

Risk Ratio (M‐H, Fixed, 95% CI)

1.35 [1.26, 1.44]

14.1 Adequately randomised trials

3

132321

Risk Ratio (M‐H, Fixed, 95% CI)

1.31 [1.22, 1.42]

14.2 Suboptimally randomised trials

2

118158

Risk Ratio (M‐H, Fixed, 95% CI)

1.42 [1.26, 1.61]

15 Number of mastectomies Show forest plot

5

250479

Risk Ratio (M‐H, Fixed, 95% CI)

1.20 [1.11, 1.30]

15.1 Adequately randomised trials

3

132321

Risk Ratio (M‐H, Fixed, 95% CI)

1.20 [1.08, 1.32]

15.2 Suboptimally randomised trials

2

118158

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [1.06, 1.38]

16 Number treated with radiotherapy Show forest plot

2

100383

Risk Ratio (M‐H, Fixed, 95% CI)

1.32 [1.16, 1.50]

16.1 Adequately randomised trials

1

42486

Risk Ratio (M‐H, Fixed, 95% CI)

1.24 [1.04, 1.49]

16.2 Suboptimally randomised trials

1

57897

Risk Ratio (M‐H, Fixed, 95% CI)

1.40 [1.17, 1.69]

17 Number treated with chemotherapy Show forest plot

2

100383

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.78, 1.19]

17.1 Adequately randomised trials

1

42486

Risk Ratio (M‐H, Fixed, 95% CI)

0.63 [0.39, 1.04]

17.2 Suboptimally randomised trials

1

57897

Risk Ratio (M‐H, Fixed, 95% CI)

1.06 [0.84, 1.34]

18 Number treated with hormone therapy Show forest plot

2

100383

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.55, 0.96]

18.1 Adequately randomised trials

1

42486

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.60, 1.08]

18.2 Suboptimally randomised trials

1

57897

Risk Ratio (M‐H, Fixed, 95% CI)

0.30 [0.12, 0.72]

19 Mortality among breast cancer patients in the Two‐County study, 7 years follow up Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

19.1 Mortality from cancers other than breast cancer

2

2063

Risk Ratio (M‐H, Fixed, 95% CI)

2.42 [1.00, 5.85]

19.2 Mortality from causes other than breast cancer

2

2063

Risk Ratio (M‐H, Fixed, 95% CI)

1.37 [0.93, 2.04]

20 Results for biased trial Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

20.1 Deaths ascribed to breast cancer, 7 years follow up

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.2 Deaths ascribed to breast cancer, 13 years follow up

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.3 Deaths ascribed to breast cancer, 7 years follow up, younger women (below 50 years of age)

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.4 Deaths ascribed to breast cancer, 7 years follow up, elderly women (at least 50 years of age)

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.5 Deaths ascribed to breast cancer, 13 years follow up, younger women (below 50 years of age)

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.6 Deaths ascribed to breast cancer, 13 years follow up, elderly women (at least 50 years of age)

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.7 Overall mortality, 7 years follow up

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

20.8 Number treated with radiotherapy

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

21 Number of cancers Show forest plot

7

512246

Risk Ratio (M‐H, Fixed, 95% CI)

1.29 [1.23, 1.35]

21.1 Adequately randomised trials (after 7‐9 years)

4

292979

Risk Ratio (M‐H, Fixed, 95% CI)

1.25 [1.18, 1.34]

21.2 Suboptimally randomised trials (before control group screen)

3

219267

Risk Ratio (M‐H, Fixed, 95% CI)

1.33 [1.24, 1.44]
Figuras y tablas -
Comparison 1. Screening with mammography versus no screening
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