Neumeyer-Gromen,A.
Gaissmaier,W.

Biller-Andorno and Jüni (2014), in a widely debated commentary published in the May 22 issue of the New England Journal of Medicine, accept the concept that mammography every 2 years from age 50 can decrease breast cancer mortality by 20%, that is, from five to four deaths per 1000 women over a 10-year period. Both the absolute and the relative risk of breast cancer death may vary depending on the baseline mortality rates in various populations and on the impact of screening mammography in reducing breast cancer mortality, which may well vary around the 20% estimate adopted. We accept, therefore, that there are still uncertainties in the absolute and relative impact of mammography screening on breast cancer mortality, given the different study schemes and mammography intervals, the differences in populations, and the continuous improvements in technology (Warner, 2011; Independent UK Panel on Breast Cancer Screening, 2012). We also agree on the observation that mammography has an appreciable impact on breast cancer mortality (Bosetti et al., 2012), but clearly a much smaller one on total mortality. A superficial reader of the perspective given by Biller-Andorno and Jüni (2014) would, however, be inclined to believe that the impact of mammography is minimal or negligible as these estimates (20% breast cancer mortality reduction or 1/1000 breast cancer deaths avoided over a 10-year period) are compared with those of a population survey on the subjective perception of mammography (Domenighetti et al., 2003). The questions in that survey were formulated in a way that was prone to overestimation of the subjective perception of benefits of mammography and led therefore to a considerable and unrealistic overestimation of the benefit of mammography by the women interviewed (Bulliard and Levi, 2004; Dumalaon-Canaria et al., 2014). Volver al principio In any case, such perceptions are not comparable with the accumulated, quantitative evidence on the favorable effects of mammography on breast cancer mortality, and cannot obscure such a widely recognized effect now.

Neumeyer-Gromen, A., & Gaissmaier, W. (2009). Screening programs. In M. W. Kattan (Ed.), Encyclopedia of medical decision making (Vol. 2, pp. 1020-1024). Los Angeles: Sage.

Publication year	2009
Document type:	In book
Publication status:	Published
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Keywords:	breast neoplasmsearly detection of cancerguidelinesmass screeningswitzerland