{"database":"biostudies-literature","file_versions":[],"scores":{"citationCount":0,"reanalysisCount":0,"viewCount":44,"searchCount":0},"additional":{"submitter":["Burnside ES"],"funding":["University of Wisconsin Carbone Cancer Center","NCATS NIH HHS","NIAID NIH HHS","NCI NIH HHS","National Institutes of Health"],"pagination":["321-328"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC6694720"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["292(2)"],"pubmed_abstract":["Background Risk-based screening in women 40-49 years old has not been evaluated in routine screening mammography practice. Purpose To use a cross-sectional study design to compare the trade-offs of risk-based and age-based screening for women 45 years of age or older to determine short-term outcomes. Materials and Methods A retrospective cross-sectional study was performed by using a database of 20 539 prospectively interpreted consecutive digital screening mammograms in 10 280 average-risk women aged 40-49 years who were screened at an academic medical center between January 1, 2006, and December 31, 2013. Two hypothetical screening scenarios were compared: an age-based (≥45 years) scenario versus a risk-based (a 5-year risk of breast cancer greater than that of an average 50-year-old) scenario. Risk factors for risk-based screening included family history, race, age, prior breast biopsy, and breast density. Outcomes included breast cancers detected at mammography, false-positive mammograms, and benign biopsy findings. Short-term outcomes were compared by using the χ<sup>2</sup> test. Results The screening population included 71 148 screening mammograms in 24 928 women with a mean age of 55.5 years ± 8.9 (standard deviation) (age range, 40-74 years). In women 40-49 years old, usual care included 50 screening-detected cancers, 1787 false-positive mammograms, and 384 benign biopsy results. The age-based (≥45 years) screening strategy revealed more cancers than did the risk-based strategy (34 [68%] vs 13 [26%] of 50; <i>P</i> < .001), while prompting more false-positive mammograms (899 [50.3%] vs 216 [12.1%] of 1787; <i>P</i> < .001) and benign biopsy results (175 [45.6%] vs 49 [12.8%] of 384; <i>P</i> < .001). The risk-based strategy demonstrated low levels of eligibility (few screenings) in the 40-44-year age group. Differences in outcomes in the 45-49-year age group explained the overall hypothetical screening strategy differences. Conclusion Risk-based screening for women 40-49 years old includes few women in the 40-44-year age range. Significant trade-offs in the 45-49-year age group explain the overall difference between hypothetical screening scenarios, both of which reduce the benefits as well as the harms of mammography for women 40-49 years old. © RSNA, 2019 <i>Online supplemental material is available for this article.</i> See also the editorial by Joe and Hayward in this issue."],"journal":["Radiology"],"pubmed_title":["Age-based versus Risk-based Mammography Screening in Women 40-49 Years Old: A Cross-sectional Study."],"pmcid":["PMC6694720"],"funding_grant_id":["U54 AI117924","UL1 TR002373","K24CA194251","P30 CA014520","P30CA014520","K24 CA194251","UL1 TR000427"],"pubmed_authors":["Schrager SB","Burnside ES","Mischo E","Wilke LG","Alagoz O","Shafer CM","Cox JR","Trentham-Dietz A","Hampton JM"],"view_count":["44"],"additional_accession":[]},"is_claimable":false,"name":"Age-based versus Risk-based Mammography Screening in Women 40-49 Years Old: A Cross-sectional Study.","description":"Background Risk-based screening in women 40-49 years old has not been evaluated in routine screening mammography practice. Purpose To use a cross-sectional study design to compare the trade-offs of risk-based and age-based screening for women 45 years of age or older to determine short-term outcomes. Materials and Methods A retrospective cross-sectional study was performed by using a database of 20 539 prospectively interpreted consecutive digital screening mammograms in 10 280 average-risk women aged 40-49 years who were screened at an academic medical center between January 1, 2006, and December 31, 2013. Two hypothetical screening scenarios were compared: an age-based (≥45 years) scenario versus a risk-based (a 5-year risk of breast cancer greater than that of an average 50-year-old) scenario. Risk factors for risk-based screening included family history, race, age, prior breast biopsy, and breast density. Outcomes included breast cancers detected at mammography, false-positive mammograms, and benign biopsy findings. Short-term outcomes were compared by using the χ<sup>2</sup> test. Results The screening population included 71 148 screening mammograms in 24 928 women with a mean age of 55.5 years ± 8.9 (standard deviation) (age range, 40-74 years). In women 40-49 years old, usual care included 50 screening-detected cancers, 1787 false-positive mammograms, and 384 benign biopsy results. The age-based (≥45 years) screening strategy revealed more cancers than did the risk-based strategy (34 [68%] vs 13 [26%] of 50; <i>P</i> < .001), while prompting more false-positive mammograms (899 [50.3%] vs 216 [12.1%] of 1787; <i>P</i> < .001) and benign biopsy results (175 [45.6%] vs 49 [12.8%] of 384; <i>P</i> < .001). The risk-based strategy demonstrated low levels of eligibility (few screenings) in the 40-44-year age group. Differences in outcomes in the 45-49-year age group explained the overall hypothetical screening strategy differences. Conclusion Risk-based screening for women 40-49 years old includes few women in the 40-44-year age range. Significant trade-offs in the 45-49-year age group explain the overall difference between hypothetical screening scenarios, both of which reduce the benefits as well as the harms of mammography for women 40-49 years old. © RSNA, 2019 <i>Online supplemental material is available for this article.</i> See also the editorial by Joe and Hayward in this issue.","dates":{"release":"2019-01-01T00:00:00Z","publication":"2019 Aug","modification":"2024-11-09T22:56:30.702Z","creation":"2019-08-21T07:03:07Z"},"accession":"S-EPMC6694720","cross_references":{"pubmed":["31184557"],"doi":["10.1148/radiol.2019181651"]}}