Comparing CISNET Breast Cancer Incidence and Mortality Predictions to Observed Clinical Trial Results of Mammography Screening from Ages 40 to 49
Year: 2018
Type: article
Abstract: BACKGROUND: The UK Age trial compared annual mammography screening of women ages 40 to 49 years with no screening and found a statistically significant breast cancer mortality reduction at the 10-year follow-up but not at the 17-year follow-up. The objective of this study was to compare the observed Age trial results with the Cancer Intervention and Surveillance Modeling Network (CISNET) breast cancer model predicted results. METHODS: Five established CISNET breast cancer models used data on population demographics, screening attendance, and mammography performance from the Age trial together with extant natural history parameters to project breast cancer incidence and mortality in the control and intervention arm of the trial. RESULTS: The models closely reproduced the effect of annual screening from ages 40 to 49 years on breast cancer incidence. Restricted to breast cancer deaths originating from cancers diagnosed during the intervention phase, the models estimated an average 15% (range across models, 13% to 17%) breast cancer mortality reduction at the 10-year follow-up compared with 25% (95% CI, 3% to 42%) observed in the trial. At the 17-year follow-up, the models predicted 13% (range, 10% to 17%) reduction in breast cancer mortality compared with the non-significant 12% (95% CI, -4% to 26%) in the trial. CONCLUSIONS: The models underestimated the effect of screening on breast cancer mortality at the 10-year follow-up. Overall, the models captured the observed long-term effect of screening from age 40 to 49 years on breast cancer incidence and mortality in the UK Age trial, suggesting that the model structures, input parameters, and assumptions about breast cancer natural history are reasonable for estimating the impact of screening on mortality in this age group.
Source: Medical Decision Making
Institutions: Erasmus MC, Georgetown University, Georgetown Lombardi Comprehensive Cancer Center, Harvard University, Dana-Farber Cancer Institute, University of Wisconsin–Madison, Stanford Medicine, Stanford University, The University of Texas MD Anderson Cancer Center, Harvard Pilgrim Health Care, Queen Mary University of London
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Comparative Modeling: Informing Breast Cancer Control Practice and Policy, Informatics Techniques to Optimize Mammography for Aging Populations, Mentoring And Research In Patient-Oriented Breast Cancer Diagnosis, Long-term follow up of a trial of annual mammographic screening from age 40, Comparative Modeling: Informing Breast Cancer Control Practice & Policy, UW Comprehensive Cancer Center Support
OpenAlex ID: W2792336645