Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation

BACKGROUND: Since the breast cancer screening programme in the Basque Country (BCSPBC) was started in 1996, more than 400,000 women aged 50 to 69 years have been invited to participate. Based on epidemiological observations and simulation techniques it is possible to extend observed short term data...

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Autores: Arrospide, Arantzazu, Rué, Montserrat, Van Ravesteyn, Nicolien T., Comas Serrano, Mercè, Larrañaga, Nerea, Sarriugarte, Garbiñe, Mar, Javier
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/25761
Acceso en línea:http://hdl.handle.net/10230/25761
http://dx.doi.org/10.1186/s12885-015-1700-4
Access Level:acceso abierto
Palabra clave:Mama -- Càncer -- País Basc
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spelling Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulationArrospide, ArantzazuRué, MontserratVan Ravesteyn, Nicolien T.Comas Serrano, MercèLarrañaga, NereaSarriugarte, GarbiñeMar, JavierMama -- Càncer -- País BascBACKGROUND: Since the breast cancer screening programme in the Basque Country (BCSPBC) was started in 1996, more than 400,000 women aged 50 to 69 years have been invited to participate. Based on epidemiological observations and simulation techniques it is possible to extend observed short term data into anticipated long term results. The aim of this study was to assess the effectiveness of the programme through 2011 by quantifying the outcomes in breast cancer mortality, life-years gained, false positive results, and overdiagnosis. METHODS: A discrete event simulation model was constructed to reproduce the natural history of breast cancer (disease-free, pre-clinical, symptomatic, and disease-specific death) and the actual observed characteristics of the screening programme during the evaluated period in the Basque women population. Goodness-of-fit statistics were applied for model validation. The screening effects were measured as differences in benefits and harms between the screened and unscreened populations. Breast cancer mortality reduction and life-years gained were considered as screening benefits, whereas, overdiagnosis and false positive results were assessed as harms. Results for a single cohort were also obtained. RESULTS: The screening programme yielded a 16 % reduction in breast cancer mortality and a 10 % increase in the incidence of breast cancer through 2011. Almost 2 % of all the women in the programme had a false positive result during the evaluation period. When a single cohort was analysed, the number of deaths decreased by 13 %, and 4 % of screen-detected cancers were overdiagnosed. Each woman with BC detected by the screening programme gained 2.5 life years due to early detection corrected by lead time. CONCLUSIONS: Fifteen years after the screening programme started, this study supports an important decrease in breast cancer mortality due to the screening programme, with reasonable risk of overdiagnosis and false positive results, and sustains the continuation of the breast cancer screening programme in the Basque population.This study was funded by the grant 2010111007 from the Health Department of the Basque Government.BioMed Central201620162015info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/25761http://dx.doi.org/10.1186/s12885-015-1700-4reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésBMC Cancer. 2015 Oct 12;15:671This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/257612026-05-29T05:05:01Z
dc.title.none.fl_str_mv Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation
title Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation
spellingShingle Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation
Arrospide, Arantzazu
Mama -- Càncer -- País Basc
title_short Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation
title_full Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation
title_fullStr Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation
title_full_unstemmed Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation
title_sort Evaluation of health benefits and harms of the breast cancer screening programme in the Basque Country using discrete event simulation
dc.creator.none.fl_str_mv Arrospide, Arantzazu
Rué, Montserrat
Van Ravesteyn, Nicolien T.
Comas Serrano, Mercè
Larrañaga, Nerea
Sarriugarte, Garbiñe
Mar, Javier
author Arrospide, Arantzazu
author_facet Arrospide, Arantzazu
Rué, Montserrat
Van Ravesteyn, Nicolien T.
Comas Serrano, Mercè
Larrañaga, Nerea
Sarriugarte, Garbiñe
Mar, Javier
author_role author
author2 Rué, Montserrat
Van Ravesteyn, Nicolien T.
Comas Serrano, Mercè
Larrañaga, Nerea
Sarriugarte, Garbiñe
Mar, Javier
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Mama -- Càncer -- País Basc
topic Mama -- Càncer -- País Basc
description BACKGROUND: Since the breast cancer screening programme in the Basque Country (BCSPBC) was started in 1996, more than 400,000 women aged 50 to 69 years have been invited to participate. Based on epidemiological observations and simulation techniques it is possible to extend observed short term data into anticipated long term results. The aim of this study was to assess the effectiveness of the programme through 2011 by quantifying the outcomes in breast cancer mortality, life-years gained, false positive results, and overdiagnosis. METHODS: A discrete event simulation model was constructed to reproduce the natural history of breast cancer (disease-free, pre-clinical, symptomatic, and disease-specific death) and the actual observed characteristics of the screening programme during the evaluated period in the Basque women population. Goodness-of-fit statistics were applied for model validation. The screening effects were measured as differences in benefits and harms between the screened and unscreened populations. Breast cancer mortality reduction and life-years gained were considered as screening benefits, whereas, overdiagnosis and false positive results were assessed as harms. Results for a single cohort were also obtained. RESULTS: The screening programme yielded a 16 % reduction in breast cancer mortality and a 10 % increase in the incidence of breast cancer through 2011. Almost 2 % of all the women in the programme had a false positive result during the evaluation period. When a single cohort was analysed, the number of deaths decreased by 13 %, and 4 % of screen-detected cancers were overdiagnosed. Each woman with BC detected by the screening programme gained 2.5 life years due to early detection corrected by lead time. CONCLUSIONS: Fifteen years after the screening programme started, this study supports an important decrease in breast cancer mortality due to the screening programme, with reasonable risk of overdiagnosis and false positive results, and sustains the continuation of the breast cancer screening programme in the Basque population.
publishDate 2015
dc.date.none.fl_str_mv 2015
2016
2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/25761
http://dx.doi.org/10.1186/s12885-015-1700-4
url http://hdl.handle.net/10230/25761
http://dx.doi.org/10.1186/s12885-015-1700-4
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv BMC Cancer. 2015 Oct 12;15:671
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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