Split (1)

train · 21.3k rows

Unnamed: 0 int64 0 21.3k	Chapter stringclasses 230 values	Section stringlengths 5 670 ⌀	Subsection stringlengths 1 120 ⌀	Subsubsection stringclasses 689 values	Text stringlengths 1 4.39k ⌀	row_counts int64 6 6	Screening float64 0 0.98	Diagnosis float64 0 0.99	Staging float64 0 0.99	Treatment float64 0 0.99	Prognosis float64 0 0.99	Follow-up float64 0 0.99	max_value float64 0 0.99	classs int64 1 6
600	Breast Cancer Screening	INTRODUCTION	null	nan nan	resonance imaging, breast examination by clinicians, and breast self-examination by individual women. We also review published data from randomized, controlled trials, popula- tion studies, and meta-analyses regarding the effects of screening programs on mortality and their potential harms, including false positive and...	6	0.05	0.07	0.08	0.09	0.06	0.04	0.09	4
601	Breast Cancer Screening	PRINCIPLES OF CANCER SCREENING	null	nan nan	The goal of breast cancer screening is early detection of disease, to be followed by appropriate treatment. Screening tests differ from diagnostic tests insofar as screening iden- tifies subgroups of people who have a high probability of	6	0.075	0.082	0.063	0.091	0.045	0.078	0.091	4
602	Breast Cancer Screening	PRINCIPLES OF CANCER SCREENING	null	nan nan	asymptomatic disease, while diagnostic tests are obtained in symptomatic patients. A positive screening result in an individual rarely provides direct evidence of disease; screen- ing tests must be followed by diagnostic tests to determine whether disease is truly present.	6	0.015	0.023	0.047	0.068	0.092	0.089	0.092	5
603	Breast Cancer Screening	PRINCIPLES OF CANCER SCREENING	Disease Requirements	nan nan	First, the disease must be serious, with significant morbid- ity or mortality. Second, an effective therapy for the disease must be available if it is detected as screening would obvi- ously have no value if subsequent treatment would not be beneficial. Third, the natural history of the disease must be understood clear...	6	0.05	0.1	0.08	0.09	0.07	0.06	0.1	2
604	Breast Cancer Screening	PRINCIPLES OF CANCER SCREENING	Screening Test Requirements and Characteristics	nan nan	It is critical to understand the characteristics of a given screening test, as well as the interplay of its characteristics with those of the population screened and the clinicians who perform and interpret the test. We present a standard 2  2 table (Table 10-1) comparing the results of screening tests with the diseas...	6	0.005	0.03	0.04	0.07	0.08	0.09	0.09	6
605	Breast Cancer Screening	PRINCIPLES OF CANCER SCREENING	Screening Test Requirements and Characteristics	nan nan	A positive test result for a person who does not have the disease assessed by a test is called a false positive result while a negative result for a person who actually has the disease is called a false negative result.	6	0.025	0.0375	0.01875	0.01875	0.04375	0.0625	0.0625	6
606	Breast Cancer Screening	PRINCIPLES OF CANCER SCREENING	Screening Test Requirements and Characteristics	nan nan	Sensitivity refers to the ability of a screening test to detect a disease when it is present and is calculated as a / (a + c).	6	0.025	0.0375	0.01875	0.04375	0.0625	0.0375	0.0625	5
607	Breast Cancer Screening	PRINCIPLES OF CANCER SCREENING	Screening Test Requirements and Characteristics	nan nan	Specificity refers to the ability of a screening test to indi- cate the absence of disease when no disease is present and is calculated as d / (b + d). If a test is not specific, it will falsely indicate the presence of disease in some people who do not have the disease; they appear in cell b.	6	0.025	0.0375	0.01875	0.01875	0.04375	0.0625	0.0625	6
608	Breast Cancer Screening	PRINCIPLES OF CANCER SCREENING	Health Care System Requirements	nan nan	A screening program divides results into positives and negatives. Follow-up within a health care system must be available for everyone who has a positive result to confirm or rule out the presence of disease. Some follow-up test- ing can be expensive, time-consuming, and painful; it may even entail a degree of risk for...	6	0.005	0.09	0.08	0.07	0.06	0.04	0.09	2
609	Breast Cancer Screening	PRINCIPLES OF CANCER SCREENING	Health Care System Requirements	nan nan	Before screening is undertaken, treatment should be available, accessible, and acceptable to people with disease. If a country’s resources are too limited to provide treatment in an equitable manner, or if no effective treatment for a given disease is available, it makes no sense, either ethically or in terms of cost-e...	6	0.025	0.0375	0.01875	0.025	0.046875	0.025	0.046875	5
610	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Screen-Film Mammography	nan nan	Screen-film mammography (SFM) has historically been the standard modality used for breast cancer screening, and the technology studied in all major randomized controlled tri- als reporting mortality benefit from screening. SFM serves as both image receptor and display medium, thus, requir- ing images to be processed mu...	6	0.005	0.01	0.04	0.01	0.02	0.025	0.04	3
611	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	Standard 2  2 Table Comparing Test Results and Disease Status of Subjects Tested, along with Formulas to Measure Test Characteristics	6	0.05	0.09	0.08	0.07	0.06	0.04	0.09	2
612	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	TEST RESULT	6	0.09	0.085	0.07	0.065	0.04	0.03	0.09	1
613	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	Positive Negative	6	0.025	0.034	0.018	0.029	0.067	0.025	0.067	5
614	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	Cells:	6	0.09	0.085	0.07	0.065	0.1	0.095	0.1	5
615	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	b = subjects with false positive test results	6	0.015	0.023	0.046	0.078	0.091	0.091	0.091	5
616	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	c = subjects with false negative test results	6	0.015	0.023	0.047	0.068	0.091	0.09	0.091	5
617	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	d = subjects with true negative test results	6	0.09	0.085	0.075	0.065	0.045	0.035	0.09	1
618	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	a + b = all subjects with positive test results	6	0.025	0.037	0.041	0.068	0.059	0.05	0.068	4
619	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	c + d = all subjects with negative test results	6	0.025	0.016	0.038	0.049	0.027	0.025	0.049	4
620	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	b + d = all subjects without disease	6	0.09	0.085	0.075	0.065	0.045	0.035	0.09	1
621	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	a / (a + c) = sensitivity	6	0.085	0.072	0.069	0.043	0.018	0.01	0.085	1
622	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	b / (b + d) = false positive error rate (alpha error rate, type I rate)	6	0.025	0.0375	0.01875	0.01875	0.046875	0.046875	0.046875	5
623	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	a / (a + b) = positive predictive value	6	0.05	0.06	0.07	0.08	0.09	0.1	0.1	6
624	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	[a / (a + c)] / [b / (b + d)] = (a / b) / [(a + c) / (b + d)] = likelihood ratio positive (LR+) [c / (a + c)] / [d / (b + d)] = (c / d) / [(a + c) / (b + d)] = likelihood ratio negative (LR–) (a + c) / (a + b + c + d) = prevalence	6	0.025	0.0375	0.01875	0.046875	0.025	0.025	0.046875	4
625	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Mammography	nan nan	Adapted from Jekel JF, Katz DL, Elmore JG. Epidemiology, biostatistics, and preventive medicine. 2nd ed. Philadelphia: W.B. Saunders, 2001.	6	0.005	0.03	0.04	0.07	0.08	0.09	0.09	6
626	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Computer-Aided Detection	nan nan	Computer-aided detection (CAD) has been found effec- tive for improving the detection of malignancy when it is used in conjunction with both SFM and FFDM (11–13). CAD was initially developed to help radiologists identify small tumors that might otherwise be overlooked, and has been shown to detect 84% to 94% of small m...	6	0	0	0	0	0	0	0	1
627	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Ultrasound	nan nan	Ultrasound serves as a critical adjunct diagnostic modality after abnormalities are noted during mammographic screen- ing, and is increasingly used as a primary diagnostic modal- ity for evaluating focal breast symptoms in women younger than age 40 (18,19). The use of ultrasound to screen asymp- tomatic women is also r...	6	0.006	0.007	0.01	0.01	0.01	0.01	0.01	3
628	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Magnetic Resonance Imaging	nan nan	the BRCA1 mutation has been shown to be cost-effective, requiring $55,420 per year of life gained (after adjustment for quality of life) (32).	6	0.098	0.076	0.089	0.095	0.092	0.091	0.098	1
629	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Magnetic Resonance Imaging	nan nan	Insufficient data are available to assess the efficacy of annual MRI screening for women who have either personal histories of breast cancer, previous diagnoses of high-risk breast lesions (e.g., atypical ductal hyperplasia or lobular carcinoma in situ), or extremely dense breasts (29). Because the specificity of scree...	6	0	0	0	0	0	0	0	1
630	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Breast Tomosynthesis	nan nan	While the sensitivity of FFDM is comparable to that of SFM, FFDM suffers from a masking effect caused by fibroglandu- lar tissue lying directly above and below tumors in two- dimensional images. The masking problem can be partially overcome by digital breast tomosynthesis (DBT). This new technology, which has received ...	6	0.09	0.085	0.1	0.095	0.09	0.08	0.1	3
631	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Digital Breast Tomosynthesis	nan nan	Initial studies comparing DBT to FFDM demonstrated comparable sensitivity and specificity for detecting cancer (38–41). By eliminating the masking problem from screening mammography, adjunct DBT has been reported to produce a 30% to 40% reduction in call-back rates compared to FFDM alone (40–42). Because about 10% of U...	6	0.005	0.09	0.07	0.06	0.08	0.08	0.09	2
632	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Breast Self-Examination	nan nan	Monthly breast self-examination (BSE) is frequently encour- aged, but evidence for its effectiveness is weak (49,50). Research has shown that teaching BSE is not associated with reduced breast cancer mortality. One RCT randomly assigned female workers in Shanghai factories either to an intervention group that received ...	6	0.02	0.03	0.06	0.07	0.01	0.01	0.07	4
633	Breast Cancer Screening	BREAST CANCER SCREENING MODALITIES	Breast Self-Examination	nan nan	Case-control studies, nonrandomized trials, and cohort studies on the effectiveness of BSE have returned mixed results, which are difficult to interpret because of possible selection and recall bias. In the U.K. Trial of Early Detection of Breast Cancer, more than 63,500 women aged 45 to 64 years were invited to educat...	6	0.08	0.09	0.07	0.08	0.08	0.08	0.09	2
634	Breast Cancer Screening	BENEFITS OF SCREENING—EFFECT ON BREAST CANCER MORTALITY AND	null	nan nan	It is difficult to establish the value of a community-based screening program unless an RCT is conducted, as RCTs are less prone to bias than other types of study designs. An improvement in survival among women who have under- gone breast cancer screening is often taken to imply that the test saves lives. However, asso...	6	0.005	0.02	0.03	0.04	0.06	0.07	0.07	6
635	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Summary of RCTs	nan nan	Screening points	6	0.085	0.067	0.092	0.043	0.012	0.021	0.092	3
636	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	The first RCT, the Health Insurance Plan of Greater New York (HIP), was met with great enthusiasm (45,66). In this trial conducted from 1963 to 1966, women aged 40 to 64 years at entry were randomized to screening versus no screen- ing. While there were slight imbalances in the distribution of women between assigned ar...	6	0.08	0.07	0.09	0.08	0.08	0.08	0.09	3
637	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	the case leading to contamination of the control groups in other subsequent RCTs. However, it is unclear whether CBE was performed with the same frequency in the two study arms. The follow-up duration for this study was 18 years with a relative risk of breast cancer death of 0.71 at 10 years, and at 0.77 at 15 years. O...	6	0.09	0.02	0.03	0.04	0.05	0.06	0.09	1
638	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	The Malmo, Sweden study, which began in 1976, invited women aged 45 to 69 years for mammography screening (69,70). This trial had 21,088 women in the intervention and 21,195 women in the control group, with 74% of women invited to screen attending their first screen, and 70% attend- ing rounds 2 to 5. The intervention ...	6	0.003	0.01	0.01	0.01	0.03	0.003	0.03	5
639	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	geographic units designed to be heterogeneous with regards to urban versus rural, population size, and socio- economic factors. Women with preexisting breast cancer were excluded from both groups. This trial enrolled approx- imately 80,000 women to screening and just over 39,000 women in the control group from Ostergot...	6	0.01	0.01	0.01	0.01	0.01	0.01	0.01	1
640	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	The Edinburgh (U.K.) Study, which commenced in 1976, enrolled women aged 45 to 64 years from 87 general prac- tices (77). Patients were randomized by clustering based on physician practices. Some randomization assignments were changed after the study began and there was inconsistent recruitment of women within practice...	6	0.005	0.01	0.01	0.01	0.01	0.01	0.01	2
641	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	The Canada National Breast Cancer Screening Study-1 (NBSS-1), which began in 1980, enrolled women aged 40 to 49 years who volunteered to participate (57). The sample size was 25,214 in the intervention group and 25,216 in the control group. The intervention consisted of annual two- view screening mammography and CBE fo...	6	0.005	0.01	0.015	0.02	0.025	0.03	0.03	6
642	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	also taking adjuvant hormone and chemotherapy following breast cancer therapy.	6	0.025	0.015	0.035	0.015	0.015	0.015	0.035	3
643	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	The Canada National Breast Cancer Screening Study-2 (NBSS-2), which also began in 1980, enrolled women 50 to 59 years of age who volunteered to participate (46). The sample size was 19,711 in the screened group and 19,694 in the control group with the intervention being annual two-view screening mammography and CBE. Th...	6	0.01	0.01	0.01	0.01	0.01	0.01	0.01	1
644	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	1981, enrolled women aged 40 to 64 years (79). Patients were randomized based on the birth date; specifically, by day of month. There were two sub-trials with a significant imbal- ance in the second with approximately 500 more women in the screened group than the control group. The sample size declined from approximate...	6	0.005	0.01	0.01	0.01	0.02	0.01	0.02	5
645	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	0.80 (0.53–1.22). The follow-up duration was 8 years and the cause of death was obtained by linking to the Swedish Cause of Death Registry. Some concerns have been raised about the randomization of this study, patient exclusions, and the delay in control group mammograms. Inclusion of these data in the Swedish meta-ana...	6	0.09	0.06	0.04	0.08	0.09	0.09	0.09	1
646	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	The Gothenburg, Sweden Trial, which began in 1982, invited women aged 39 to 59 years old (63,80). The random- ization method was complex, with women clustered ran- domly by their day of birth within their birth year for the older group (50 to 59 years old) and by individual for the younger group (39 to 49 years old). T...	6	0.01	0.01	0.01	0.01	0.01	0.01	0.01	1
647	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Overview of Individual RCTs	nan nan	The AGE Trial enrolled women aged 39 to 41 years from 1991 to 1997, and included 160,921 women (65). Women were randomized to screening with annual two-view mam- mography until age 48, or usual care for the control group. Patients were randomized based on lists of general practi- tioners in geographically defined areas...	6	0.005	0.01	0.01	0.01	0.01	0.01	0.01	2
648	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	Meta-analyses of the RCTs have been published by different authors using varying analytic methods, with some authors excluding specific trials due to concerns about quality of the	6	0.09	0.085	0.07	0.065	0.1	0.1	0.1	5
649	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	A meta-analysis of RCTs conducted for the U.S. Preventive Services Task Force in 2009, shown in Table 10-2, found that the number needed to invite to screen for 10 years to avoid or delay one death from breast cancer was 1,904 for women in their 40s, 1,339 for women in their 50s and 377 for women in their 60s (81). The...	6	0.09	0.09	0.09	0.09	0.09	0.09	0.09	1
650	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	Study Name N	6	0.5	0.3	0.2	0.1	0.4	0.6	0.6	6
651	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	*HIP 40-64yrs (1963)	6	0.005	0.02	0.07	0.08	0.01	0.001	0.08	4
652	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	**Malmo 45-70yrs (1976)	6	0.23	0.8	0.1	0.1	0.1	0.1	0.8	2
653	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	*Kopparberg 40-74yrs (1977)	6	0.5	0.2	0.3	0.2	0.2	0.2	0.5	1
654	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	*Ostergotland 40-74yrs (1977)	6	0.5	0.2	0.3	0.2	0.2	0.2	0.5	1
655	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	*Edinburgh 45-64yrs (1978)	6	0	0.2	0.3	0.4	0.5	0.6	0.6	6
656	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	**Canada_a 40-49yrs (1980)	6	0.005	0.02	0.03	0.07	0.06	0.01	0.07	4
657	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	Stockholm 40-64yrs (1981)	6	0.5	0.2	0.3	0.2	0.2	0.2	0.5	1
658	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	Goteborg 39-59yrs (1982) UK Age 39-41yrs (1991)	6	0.06	0.07	0.08	0.09	0.08	0.07	0.09	4
659	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	33010	6	0.005	0.02	0.04	0.07	0.08	0.09	0.09	6
660	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	41478	6	0.5	0.2	0.3	0.1	0.1	0.1	0.5	1
661	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	57171	6	0.09	0.08	0.06	0.04	0.03	0.02	0.09	1
662	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	75894	6	0.1	0.2	0.3	0.4	0.5	0.6	0.6	6
663	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	32897	6	0.1	0.5	0.4	0.6	0.2	0.1	0.6	4
664	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	50430	6	0.1	0.2	0.3	0.4	0.5	0.6	0.6	6
665	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	39405	6	0.1	0.2	0.3	0.4	0.5	0.6	0.6	6
666	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	60261	6	0.5	0.4	0.3	0.2	0.1	0.9	0.9	6
667	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	25941	6	0.03	0.06	0.08	0.07	0.05	0.04	0.08	3
668	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	160840	6	0.005	0.02	0.03	0.07	0.09	0.01	0.09	5
669	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	0.1 1	6	0.5	0.2	0.3	0.4	0.6	0.7	0.7	6
670	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	0.809 (0.610, 1.072)	6	0.5	0.4	0.3	0.5	0.5	0.5	0.5	1
671	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	0.583 (0.450, 0.756)	6	0.1	0.2	0.3	0.4	0.5	0.5	0.5	5
672	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	0.758 (0.606, 0.949)	6	0.1	0.2	0.3	0.4	0.5	0.5	0.5	5
673	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	0.884 (0.695, 1.125)	6	0.075	0.033	0.05	0.05	0.05	0.05	0.075	1
674	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	0.546 (0.313, 0.951)	6	0.2	0.2	0.2	0.2	0.2	0.2	0.2	1
675	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	0.830 (0.661, 1.043)	6	0.095	0.075	0.08	0.08	0.08	0.08	0.095	1
676	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	0.809 (0.742, 0.883)	6	0.1	0.1	0.1	0.1	0.1	0.1	0.1	1
677	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	10	6	0.5	0.2	0.3	0.4	0.6	0.7	0.7	6
678	Breast Cancer Screening	RANDOMIZED CLINICAL TRIALS OF SCREENING MAMMOGRAPHY	Meta-Analyses and Reviews of RCT Data	nan nan	FIGURE 10-2 Example results of a meta-analysis of randomized clinical trials of breast cancer screening. (From Glasziou P, Houssami N. The evidence base for breast cancer screening. Prev Med 2011;53(3).)	6	0.098	0.076	0.042	0.089	0.089	0.098	0.098	1
679	Breast Cancer Screening	COMMENTS ON OTHER BENEFITS	null	nan nan	OF SCREENING	6	0.05	0.02	0.01	0.03	0.04	0.06	0.06	6
680	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	False Positive Results and Additional Interventions	nan nan	Clinicians face the challenge of minimizing the number of women who are unnecessarily called back for diagnostic follow-up after a screening exam while maximizing the likeli- hood of detecting all potentially lethal cancers. This situa- tion can be compared to the performance of a home smoke detector—you don’t want an ...	6	0.015	0.023	0.047	0.068	0.092	0.089	0.092	5
681	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	False Positive Results and Additional Interventions	nan nan	Most women who are screened for breast cancer are free of disease. In the United States, approximately one in 10 women who are screened with mammography receive false positive results and are recalled for additional testing, even though they do not have breast cancer (90,91). The availability of prior test results for ...	6	0.005	0.08	0.07	0.06	0.04	0.09	0.09	6
682	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	False Positive Results and Additional Interventions	nan nan	Most data on false positive results in breast cancer screening refer to rates per mammogram instead of rates per woman over the lifespan. This approach ignores the fact that many women undergo screening over a period of decades, and thus could receive 10, 20, or more exams dur- ing their lives. A retrospective study pu...	6	0.07	0.08	0.09	0.1	0.09	0.08	0.1	4
683	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	False Positive Results and Additional Interventions	nan nan	while the cumulative risk after 10 CBEs was only 22.3% (95% CI, 19.2–27.5). False positive results among study participants led to 870 outpatient appointments, 539 diagnostic mammo- grams, 186 ultrasound examinations, and 188 biopsies. In one patient, a false positive mammogram prompted a biopsy that resulted in cellul...	6	0.1	0.1	0.1	0.1	0.1	0.1	0.1	1
684	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	False Positive Results and Additional Interventions	nan nan	A subsequent study that modeled data from the same cohort of women found that the likelihood of a false posi- tive mammogram varied widely based on characteristics of the women screened, the screening modality used, and the radiologist who interpreted the exam (94). The cumulative risk of receiving at least one false p...	6	0.2	0.3	0.2	0.2	0.2	0.2	0.3	2
685	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	False Negative Results and False Sense of Security	nan nan	by the radiologist or clinician, or because no lesion was vis- ible or palpable on examination. For example, if screening mammography has a sensitivity of 80%, then 20% of mammo- grams of women who will be diagnosed with breast cancer within 1 year will be interpreted as negative. These women, as well as their primary ...	6	0.095	0.075	0.06	0.04	0.03	0.02	0.095	1
686	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Radiation Exposure	nan nan	FIGURE 10-3 A woman’s estimated risk of having at least one false positive screening mammogram, according to the total number of screening mammograms performed. NOTE: Numbers in parentheses denote numbers of women with at least that many mammograms. I bars indicate 95% confidence intervals. (From Elmore JG, Barton MB, ...	6	0.08	0.07	0.06	0.04	0.02	0.01	0.08	1
687	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Radiation Exposure	nan nan	et al. Ten-year risk of false positive screening mammograms and clinical breast examina- tions. N Engl J Med 1998;338(16):1089–1096.)	6	0.025	0.04	0.075	0.1	0.1	0.1	0.1	4
688	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Radiation Exposure	nan nan	60	6	0.5	0.4	0.3	0.2	0.1	0.1	0.5	1
689	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Radiation Exposure	nan nan	0	6	0.1	0.95	0.8	0.7	0.6	0.4	0.95	2
690	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Radiation Exposure	nan nan	1 2 3 4 5 6	6	0.08	0.07	0.09	0.06	0.05	0.04	0.09	3
691	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Radiation Exposure	nan nan	7 8 9 10	6	0.5	0.3	0.2	0.4	0.6	0.1	0.6	5
692	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Radiation Exposure	nan nan	(2227) (2073) (1843) (1491) (1062)	6	0.005	0.01	0.01	0.01	0.01	0.01	0.01	2
693	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Radiation Exposure	nan nan	(636)	6	0.05	0.1	0.02	0.08	0.09	0.07	0.1	2
694	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Radiation Exposure	nan nan	(23)	6	0.05	0.07	0.08	0.09	0.06	0.04	0.09	4
695	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Discomfort, Anxiety, and Distress	nan nan	Compression of the breasts is required during mammogra- phy in order to create uniform breast density, improve image resolution, and reduce radiation dose. A systematic review of studies examining physical pain and discomfort associated with mammography demonstrates that while most women experience some physical discom...	6	0.005	0.02	0.04	0.07	0.08	0.09	0.09	6
696	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Discomfort, Anxiety, and Distress	nan nan	In general, women do not react well to hearing that their screening mammogram is “abnormal” and that they might have breast cancer. In such situations, women typi- cally experience a heightened sense of their risk of cancer. Further, when media campaigns publicize that “one in eight women will be diagnosed with breast ...	6	0.015	0.02	0.03	0.01	0.01	0.025	0.03	3
697	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Discomfort, Anxiety, and Distress	nan nan	(104). One survey of women 3 months after screening mam- mography found that about one-quarter of those who initially received an abnormal result were still experiencing worry that affected their mood or functioning, even though subsequent testing had already ruled out a cancer diagnosis (105). Such worry and anxiety m...	6	0.002	0.098	0.007	0.098	0.098	0.098	0.098	2
698	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Overdiagnosis	nan nan	Overdiagnosis of breast cancer refers to the diagnosis of a neoplasm that would never become clinically apparent with- out screening before a patient’s death from other causes (107). Because cancers that will progress cannot be distinguished with certainty from those that will not, any tumor identified by screening is ...	6	0.095	0.08	0.06	0.04	0.02	0.03	0.095	1
699	Breast Cancer Screening	POTENTIAL HARMS OF SCREENING	Overdiagnosis	nan nan	radiation, chemotherapy, and hormonal therapy. In some cases this regimen might constitute overtreatment because it confers no benefit unless the tumor will actually progress.	6	0.015	0.023	0.047	0.068	0.092	0.087	0.092	5

Subsets and Splits

No community queries yet

The top public SQL queries from the community will appear here once available.