How does age affect baseline screening mammography performance measures? A decision model
2008

Impact of Age on Mammography Performance

publication Evidence: moderate

Author Information

Author(s): Keen John D, Keen James E

Hypothesis

How does age affect baseline screening mammography performance measures?

Conclusion

Breast cancer prevalence, the cancer detection rate, and all secondary screening mammography performance measures increase substantially with age.

Supporting Evidence

  • The cancer detection rate increases from 1.9/1000 at age 40 to 15.1/1000 at age 60.
  • The recall rate remains stable at 142–157/1000.
  • The positive predictive value of a screening mammogram increases from 1.3% at age 40 to 9.8% at age 60.
  • The positive biopsy fraction varies from 6% at age 40 to 32% at age 60.

Takeaway

As women get older, mammograms are better at finding breast cancer, but they also lead to more false alarms.

Methodology

A decision tree model was constructed to predict outcomes of baseline screening mammograms in women aged 35 to 65, comparing screening with no screening.

Potential Biases

Potential bias in the data due to reliance on historical accuracy data and the influence of overdiagnosis.

Limitations

The model only considers the decision to undergo a baseline exam and does not account for subsequent screenings or the effects of overdiagnosis.

Participant Demographics

Women aged 35 to 65.

Digital Object Identifier (DOI)

10.1186/1472-6947-8-40

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