|dc.identifier.citation||Jacklyn G, Glasziou P, Macaskill P, Barratt A. Meta-analysis of breast cancer mortality benefit and overdiagnosis adjusted for adherence: improving information on the effects of attending screening mammography. Br J Cancer. 2016 May 24;114(11):1269-76. doi: 10.1038/bjc.2016.90||en_AU|
|dc.description.abstract||Background: Women require information about the impact of regularly attending screening mammography on breast cancer mortality and overdiagnosis to make informed decisions. To provide this information we aimed to meta-analyse randomised controlled trials adjusted for adherence to the trial protocol.
Methods: Nine screening mammography trials used in the Independent UK Breast Screening Report were selected. Extending an existing approach to adjust intention-to-treat (ITT) estimates for less than 100% adherence rates, we conducted a random-effects meta-analysis. This produced a combined deattenuated prevented fraction and a combined deattenuated percentage risk of overdiagnosis.
Results: In women aged 39–75 years invited to screen, the prevented fraction of breast cancer mortality at 13-year follow-up was 0.22 (95% CI 0.15–0.28) and it increased to 0.30 (95% CI 0.18–0.42) with deattenuation. In women aged 40–69 years invited to screen, the ITT percentage risk of overdiagnosis during the screening period was 19.0% (95% CI 15.2–22.7%), deattenuation increased this to 29.7% (95% CI 17.8–41.5%).
Conclusions: Adjustment for nonadherence increased the size of the mortality benefit and risk of overdiagnosis by up to 50%. These estimates are more appropriate when developing quantitative information to support individual decisions about attending screening mammography.||en_AU|
|dc.publisher||British Journal of Cancer||en_AU|
|dc.relation||NHMRC grant no. 1074626||en_AU|
|dc.title||Meta-analysis of breast cancer mortality benefit and overdiagnosis adjusted for adherence: improving information on the effects of attending screening mammography||en_AU|
|dc.subject.asrc||FoR::111799 - Public Health and Health Services not elsewhere classified||en_AU|
|dc.description.addcoll||Sydney School of Public Health||en_AU|
|Appears in Collections:||Research Papers and Publications. Public Health|