JSM 2004 - Toronto

Abstract #300212

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Activity Number: 31
Type: Invited
Date/Time: Sunday, August 8, 2004 : 4:00 PM to 5:50 PM
Sponsor: Cmte on Women in Statistics
Abstract - #300212
Title: Whom Do We Reach? Breast Screening for Women after 70
Author(s): Leslie A. Gaudette*+ and Robert A. Spasoff
Companies: Health Canada and University of Ottawa
Address: Centre for Chronic Disease Prevention and Control, Ottawa, ON, K1A 1B4, Canada
Keywords: screening mammography ; evaluation ; breast cancer ; elderly ; modeling ; population health
Abstract:

Established evaluation criteria were used to assess population health impacts of extending population-based breast cancer screening to Canadian women aged 70-79. Experimental evidence and empirical data were reviewed; the MISCAN microsimulation model, adapted to the Canadian population, estimated benefits and harms. Depending upon screening participation level and sojourn time, continuing to screen women aged 70-79 resulted in an estimated 534 to 569 false positive mammograms per 10,000 screens, 22 to 42 additional biopsies, 10 to 25 extra cancers, and 12.2 to 13.7 prevented cancer deaths, and about 30 fewer women diagnosed with stage T2+ cancer. Quality adjustment of life-years gained reduced the benefit by up to 31% to 48% depending upon discount factor and sojourn times. Between 733 and 821 screens are needed to avert one breast cancer death; the gain in life expectancy is about four days per screen. An estimated 459 breast cancer deaths can be prevented per year in Canada if the national target level of 70% screening participation is reached in women aged 70-79. Overall, favorable population health impacts were found for extending breast cancer screening to women aged 70-79.

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