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Cancers 2011, 3(1), 252-266; doi:10.3390/cancers3010252

Rational and Irrational Issues in Breast Cancer Screening

Dalla Lana School of Public Health, University of Toronto, 155 College Street, Ste 576, Toronto, Ontario, M5T 3M7, Canada
Received: 15 December 2010 / Revised: 3 January 2011 / Accepted: 6 January 2011 / Published: 11 January 2011
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Evidence on the efficacy of breast screening from randomized controlled trials conducted in the last decades of the 1900s is reviewed. For decades, controversy about their results has centered on the magnitude of benefit in terms of breast cancer mortality reduction that can be achieved. However more recently, several expert bodies have estimated the benefits to be smaller than initially expected and concerns have been raised about screening consequences such as over-diagnosis and unnecessary treatment. Trials with substantial mortality reduction have been lauded and others with null effects have been critiqued. Critiques of the Canadian National Breast Screening Study are refuted. Extreme responses by screening advocates to the United States Preventive Services Task Force 2009 guidelines are described. The role vested interests play in determining health policy is clearly revealed in the response to the guidelines and should be more generally known. A general reluctance to explore unexpected results or to accept new paradigms is briefly discussed.
Keywords: breast screening; screening mammography; randomized controlled trials breast screening; screening mammography; randomized controlled trials
This is an open access article distributed under the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Baines, C.J. Rational and Irrational Issues in Breast Cancer Screening. Cancers 2011, 3, 252-266.

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