Abstract
A large-scale trial has been started in the United Kingdom with the aim of evaluating the effectiveness of different methods for the early detection of breast cancer. Two populations, each of 25,000 women aged 45-64 are invited for annual screening by mammography and/or clinical examination. Two further populations, one of 25,000 and one of 40,000 women in the same age range, are invited for education sessions in breast self-examination, and 4 control populations, totalling 120,000 women, are offered no additional services beyond conventional diagnostic facilities. All breast histology, both benign and malignant, in all women in the study is recorded, as are the findings, management and follow-up of all breast cancers. Changes in the populations, and deaths from all causes, are also recorded. This is essentially a non-randomized trial, though in one of the screening centres, where an education programme about breast cancer is provided for the whole population, only women registered with certain randomly selected general practices are invited to be screened. The principal means of evaluation will be the comparison of the mortality rates from breast cancer in each of the study populations. Costs, in terms of use of health resources, unnecessary surgery and radiation hazard, will be assessed. Additional aspects of the trial include studies of women's attitudes to early detection, and of the aetiology of breast cancer.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bonadonna G. Adjuvant chemotherapy of breast cancer. Br J Hosp Med. 1980 Jan;23(1):40–passim. [PubMed] [Google Scholar]
- Chamberlain J., Clifford R. E., Nathan B. E., Price J. L., Burn I. Error-rates in screening for breast cancer by clinical examination and mammography. Clin Oncol. 1979 Jun;5(2):135–146. [PubMed] [Google Scholar]
- Farquhar J. W. The community-based model of life style intervention trials. Am J Epidemiol. 1978 Aug;108(2):103–111. doi: 10.1093/oxfordjournals.aje.a112593. [DOI] [PubMed] [Google Scholar]
- Feinleib M., Zelen M. Some pitfalls in the evaluation of screening programs. Arch Environ Health. 1969 Sep;19(3):412–415. doi: 10.1080/00039896.1969.10666863. [DOI] [PubMed] [Google Scholar]
- Gilbertsen V. A., Church T. R., Grewe F. J., Mandel J. S., McHugh R. B., Schuman L. M., Williams S. E. The design of a study to assess occult-blood screening for colon cancer. J Chronic Dis. 1980;33(2):107–114. doi: 10.1016/0021-9681(80)90034-x. [DOI] [PubMed] [Google Scholar]
- Kelsey J. L. A review of the epidemiology of human breast cancer. Epidemiol Rev. 1979;1:74–109. doi: 10.1093/oxfordjournals.epirev.a036215. [DOI] [PubMed] [Google Scholar]
- Lundgren B. Population screening for breast cancer by single-view mammography in a geographic region in Sweden. J Natl Cancer Inst. 1979 Jun;62(6):1373–1379. [PubMed] [Google Scholar]
- Ramcharan S., Cutler J. L., Feldman R., Siegelaub A. B., Campbell B., Friedman G. D., Dales L. G., Collen M. F. Multiphasic checkup evaluation study. 2. Disabilty and chronic disease after seven years of multiphasic health checkups. Prev Med. 1973 Jun;2(2):207–220. doi: 10.1016/0091-7435(73)90065-0. [DOI] [PubMed] [Google Scholar]
- Shapiro S., Goldberg J. D., Hutchison G. B. Lead time in breast cancer detection and implications for periodicity of screening. Am J Epidemiol. 1974 Nov;100(5):357–366. doi: 10.1093/oxfordjournals.aje.a112046. [DOI] [PubMed] [Google Scholar]