Table 2.
Median Lifetime Benefits and Harms (and Range across Models) of Mammography Screening Strategies per 1000 Women Screened Compared with No Screening According to Screening Modality, Interval, Starting Age, and Stopping Age
| Strategy | Mammograms | Median Lifetime Benefits | Median Lifetime Harms | |||||
|---|---|---|---|---|---|---|---|---|
| Breast Cancer Mortality Reduction, % | Breast Cancer Deaths Averted | Life-Years Gained | False-positive Recalls | Benign Biopsies | Over-diagnosed Cases b | |||
| Digital Mammography until Age 74 a | ||||||||
| Biennial | ||||||||
| 50–74 | 11,192 (10,999–11,278) | 24.3 (18.3–27.5) | 6.9 (4.8–8.6) | 114.6 (109.8–165.0) | 1,021 (1,003–1,027) | 148 (146–149) | 10 (4–29) | |
| 45–74 | 13,283 (13,078–13,380) | 26.4 (20.4–29.3) | 7.8 (5.1–9.2) | 140.0 (125.0–187.7) | 1,230 (1,212–1,238) | 173 (170–174) | 11 (4–30) | |
| 40–74 | 16,092 (15,863–16,215) | 28.4 (22.3–31.7) | 8.4 (5.6–10.1) | 170.1 (141.2–214.1) | 1,540 (1,520–1,551) | 210 (207–212) | 12 (4–33) | |
| Hybrid | ||||||||
| A45–49, B50–74 | 15,992 (15,807–16,164) | 29.3 (22.4–30.5) | 8.6 (5.7–9.6) | 151.3 (140.8–194.5) | 1,416 (1,400–1,430) | 189 (187–191) | 19 (4–33) | |
| A45–54, B55–74 | 18,006 (17,804–18,197) | 29.3 (23.0–30.2) | 8.8 (5.8–9.4) | 159.3 (148.6–195.5) | 1,514 (1,497–1,530) | 195 (193–197) | 19 (4–33) | |
| A40–49, B50–74 | 20,898 (20,705–21,133) | 31.7 (24.4–33.1) | 9.3 (6.2–10.7) | 178.9 (161.9–234.6) | 1,896 (1,879–1,916) | 236 (234–239) | 21 (4–35) | |
| Annual | ||||||||
| 50–74 | 21,439 (21,010–21,650) | 29.4 (24.7–31.7) | 9.2 (6.8–9.5) | 153.2 (134.0–181.4) | 1,543 (1,513–1,557) | 192 (188–194) | 16 (5–39) | |
| 45–74 | 26,272 (25,776–26,526) | 33.4 (29.8–35.4) | 10.4 (7.5–11.8) | 187.3 (163.6–230.1) | 1,943 (1,907–1,960) | 233 (229–235) | 18 (5–43) | |
| 40–74 | 31,178 (30,649–31,493) | 35.2 (31.8–37.6) | 11.0 (8.0–13.1) | 208.7 (200.7–275.5) | 2,423 (2,385–2,446) | 281 (276–283) | 19 (5–45) | |
| Digital Mammography until Age 79 | ||||||||
| Biennial | ||||||||
| 50–79 | 12,456 (12,223–12,560) | 26.9 (22.2–30.2) | 7.9 (5.6–9.4) | 122.7 (118.5–172.8) | 1,105 (1,084–1,113) | 160 (157–161) | 12 (6–34) | |
| 45–79 | 15,176 (14,907–15,297) | 31.7 (24.8–33.3) | 8.9 (6.3–11.9) | 145.6 (137.8–202.5) | 1,356 (1,333–1,366) | 191 (187–192) | 14 (6–37) | |
| 40–79 | 17,354 (17,081–17,494) | 32.9 (25.3–34.9) | 9.1 (6.4–12.3) | 176.8 (149.8–233.9) | 1,624 (1,601–1,636) | 222 (219–223) | 14 (6–37) | |
| Hybrid | ||||||||
| A45–49, B50–79 | 17,242 (17,026–17,443) | 31.8 (25.4–33.1) | 9.4 (6.4–11.7) | 156.7 (149.5–209.4) | 1,499 (1,481–1,516) | 200 (198–203) | 22 (6–37) | |
| A45–54, B55–79 | 19,876 (19,627–20,112) | 33.9 (27.5–34.2) | 10.0 (6.9–12.4) | 168.8 (158.7–217.2) | 1,639 (1,618–1,658) | 213 (210–215) | 24 (6–40) | |
| A40–49, B50–79 | 22,150 (21,921–22,412) | 34.9 (27.4–36.2) | 10.1 (6.9–13.1) | 187.9 (170.5–257.0) | 1,979 (1,960–2,002) | 248 (245–251) | 24 (6–40) | |
| Annual | ||||||||
| 50–79 | 24,563 (24,014–24,831) | 33.7 (32.1–35.8) | 10.5 (7.9–12.2) | 172.7 (145.8–192.7) | 1,716 (1,678–1,733) | 212 (208–214) | 19 (7–46) | |
| 45–79 | 29,389 (28,767–29,702) | 38.1 (35.1–39.5) | 11.6 (8.9–14.8) | 202.9 (172.0–256.1) | 2,115 (2,072–2,136) | 253 (248–256) | 21 (7–50) | |
| 40–79 | 34,289 (33,633–34,667) | 41.7 (37.2–42.9) | 12.2 (9.4–16.1) | 224.3 (211.4–300.6) | 2,595 (2,550–2,621) | 301 (295–304) | 23 (7–52) | |
| Digital Breast Tomosynthesis until Age 74 c | ||||||||
| Biennial | ||||||||
| 50–74 | 11,208 (10,976–11,278) | 25.4 (18.8–29.4) | 6.7 (5.1–9.2) | 120.8 (115.1–175.8) | 873 (855–878) | 136 (133–137) | 12 (4–33) | |
| 45–74 | 13,299 (13,051–13,380) | 27.5 (21.7–31.2) | 7.5 (5.5–9.8) | 141.3 (133.9–200.1) | 1,080 (1,061–1,086) | 164 (161–165) | 13 (4–34) | |
| 40–74 | 16,116 (15,826–16,214) | 30.0 (24.0–33.7) | 8.2 (6.1–10.6) | 165.2 (152.4–221.9) | 1,376 (1,354–1,384) | 201 (198–203) | 14 (4–37) | |
| Hybrid | ||||||||
| A45–49, B50–74 | 16,053 (15,775–16,164) | 29.5 (23.9–32.5) | 8.0 (6.0–10.2) | 153.5 (146.3–207.2) | 1,242 (1,221–1,250) | 184 (180–185) | 19 (4–37) | |
| A45–54, B55–74 | 18,072 (17,772–18,197) | 29.9 (24.4–32.1) | 8.2 (6.2–10.0) | 161.1 (148.2–207.9) | 1,317 (1,296–1,326) | 193 (189–194) | 20 (4–37) | |
| A40–49, B50–74 | 20,979 (20,662–21,133) | 32.2 (26.1–34.4) | 8.8 (6.6–11.0) | 181.2 (163.9–240.1) | 1,691 (1,667–1,703) | 238 (233–240) | 21 (4–39) | |
| Annual | ||||||||
| 50–74 | 21,500 (20,963–21,650) | 30.6 (24.7–32.8) | 8.6 (7.0–10.1) | 155.6 (137.1–191.7) | 1,277 (1,246–1,285) | 186 (182–187) | 18 (5–42) | |
| 45–74 | 26,349 (25,716–26,526) | 34.1 (31.4–36.5) | 9.7 (7.9–11.8) | 193.3 (165.7–230.1) | 1,647 (1,610–1,657) | 234 (229–235) | 20 (5–46) | |
| 40–74 | 31,273 (30,572–31,492) | 37.0 (33.6–38.9) | 10.3 (8.5–13.1) | 216.6 (190.1–274.9) | 2,096 (2,055–2,110) | 288 (283–290) | 21 (5–48) | |
| Digital Breast Tomosynthesis until Age 79 | ||||||||
| Biennial | ||||||||
| 50–79 | 12,488 (12,193–12,560) | 28.0 (23.6–32.2) | 7.6 (6.0–10.1) | 129.3 (119.6–184.1) | 937 (916–943) | 144 (141–145) | 14 (6–38) | |
| 45–79 | 15,218 (14,871–15,297) | 32.1 (26.5–35.5) | 8.6 (6.7–12.1) | 153.4 (147.7–213.1) | 1,176 (1,153–1,183) | 176 (173–177) | 16 (6–41) | |
| 40–79 | 17,397 (17,037–17,494) | 33.3 (27.2–36.5) | 8.9 (6.9–12.5) | 173.9 (161.7–237.8) | 1,440 (1,415–1,449) | 210 (206–211) | 17 (6–42) | |
| Hybrid | ||||||||
| A45–49, B50–79 | 17,325 (16,987–17,443) | 32.5 (27.2–35.3) | 8.9 (6.9–11.9) | 160.5 (152.8–215.4) | 1,306 (1,282–1,315) | 192 (188–193) | 22 (6–42) | |
| A45–54, B55–79 | 19,980 (19,585–20,112) | 34.1 (29.2–36.4) | 9.2 (7.4–12.6) | 172.7 (161.0–220.8) | 1,413 (1,387–1,423) | 205 (202–207) | 24 (6–44) | |
| A40–49, B50–79 | 22,255 (21,870–22,412) | 35.3 (29.4–37.2) | 9.5 (7.4–13.3) | 188.7 (173.4–260.1) | 1,755 (1,728–1,768) | 247 (242–248) | 24 (6–44) | |
| Annual | ||||||||
| 50–79 | 24,687 (23,953–24,831) | 34.5 (32.6–36.9) | 9.8 (8.0–12.2) | 173.2 (148.2–203.6) | 1,405 (1,367–1,417) | 202 (197–204) | 22 (7–50) | |
| 45–79 | 29,517 (28,692–29,701) | 39.1 (37.1–40.8) | 10.9 (9.0–14.8) | 207.1 (176.1–255.8) | 1,774 (1,730–1,789) | 250 (244–252) | 24 (7–54) | |
| 40–79 | 34,441 (33,538–34,666) | 41.7 (39.2–43.0) | 11.5 (9.9–16.1) | 229.7 (200.4–300.7) | 2,224 (2,175–2,240) | 304 (298–307) | 25 (7–56) | |
Abbreviations: A, annual; B, biennial.
a
Digital mammography strategies show results for Models D, E, GE, M, and W.
b
Over-diagnosed cases are in situ and invasive breast cancer cases that would not have been clinically detected in the absence of screening. Overdiagnosis is calculated by subtracting the number of cases detected in the screening scenario from the number of cases detected in the no-screening scenario. Model S (Stanford University) is excluded because it does not include DCIS.
c
Digital breast tomosynthesis strategies show results for Models D, E, GE, M, S, and W.