Contemporary Evaluation of Breast Cancer Screening

William E. Barlow ()
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William E. Barlow: Cancer Research and Biostatistics

A chapter in Frontiers of Biostatistical Methods and Applications in Clinical Oncology, 2017, pp 331-342 from Springer

Abstract: Abstract Mammography screening has been shown in randomized trials to reduce breast cancer mortalityCancer mortality by at least 20%, though it has risks as well due to radiation exposure and overtreatment of benign conditions. However, mammography technology and breast cancer treatment have improved since these trials were conducted and it is unlikely that large scale trials will ever be conducted again. Therefore,Prospective prospective observational data need to be used to continuously assess improvements in the screening process. We consider the successive steps for a woman undergoing screening and attempt to measure and improve each step in that process to maximize benefits while monitoring harms of screening. A large population-based study entitled PROSPR is assessing longitudinal performance of screening mammography and showing areas where improvements in follow-up of positive mammograms need to be made. In this assessment we consider sources of biasBias in evaluation of observational data when assessing efficacy of screening. We also propose a chained statistical model to look at steps in the overall process from screening participation to mortality.

Keywords: Cancer screening; Observational data bias; Test performance; Risk modeling; Sequential processes (search for similar items in EconPapers)
Date: 2017
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Persistent link: https://EconPapers.repec.org/RePEc:spr:sprchp:978-981-10-0126-0_20

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DOI: 10.1007/978-981-10-0126-0_20

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