Rethinking Screening for Breast Cancer and Prostate Cancer

Department of Surgery and Radiology, University of California, San Francisco, San Francisco, CA 94115, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 10/2009; 302(15):1685-92. DOI: 10.1001/jama.2009.1498
Source: PubMed


After 20 years of screening for breast and prostate cancer, several observations can be made. First, the incidence of these cancers increased after the introduction of screening but has never returned to prescreening levels. Second, the increase in the relative fraction of early stage cancers has increased. Third, the incidence of regional cancers has not decreased at a commensurate rate. One possible explanation is that screening may be increasing the burden of low-risk cancers without significantly reducing the burden of more aggressively growing cancers and therefore not resulting in the anticipated reduction in cancer mortality. To reduce morbidity and mortality from prostate cancer and breast cancer, new approaches for screening, early detection, and prevention for both diseases should be considered.

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    • "Women were also asked how they felt about the DCIS term itself as well as other alternative terms for DCIS that have been proposed (see Table 3). These terms included ductal intraepithelial neoplasia (DIN) introduced in 1988 by Tavassoli [30], indolent lesions of epithelial origin (IDLE) advocated for by Esserman and colleagues [13] and a plain language description of abnormal cells currently used in the LORIS trial (abnormal cells in the milk duct of the breast that had not spread into other breast tissue) [21]. When told the DCIS terminology, women appeared overwhelmed by the language and typically only recognised the term carcinoma. "
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