Screening

Mammographic surveillance in women younger than 50 years who have a family history of breast cancer: tumour characteristics and projected effect on mortality in the prospective, single-arm, FH01 study FH01 collaborative teams. Lancet Oncol. 11, 1127–1134 (2010)

Women with a family history of breast cancer can be divided into three groups: high risk, medium risk, and low risk. In the FH01 study, 6,710 medium-risk women (with a family history that indicates their risk is higher than average) under 50 years were enrolled to annual mammography screening for a mean period of 4 years. This group was compared with a control cohort of women from the 'Age' trial and a Dutch group of women. Predicted 10-year mortality was significantly lower in the FH01 group than the control groups. Therefore, annual screening is likely to be an effective preventative measure in these medium-risk individuals.

Diagnosis

False-positive results in the randomized controlled trial of mammographic screening from age 40 (“Age” trial) Johns, L. E. et al. Cancer Epidemiol. Biomarkers Prev. 19, 2758–2764 (2010)

A drawback of breast cancer screening is the high number of false-positive results. Data from the 'Age' trial—that included 53,884 women aged 40 and over—have been used to analyze the frequency and impact of a false-positive result. The present study revealed a cumulative false-positive rate of 20.5% over seven screens, which was similar to the rate in the national screening program. This outcome equated to 7,893 women receiving at least one false-positive result. Importantly, 89% of these women attended their next appointment for a routine scan indicating that the experience of a false-positive result does not deter women from undergoing future routine tests.

Screening

Effect of repeated invitations on uptake of colorectal cancer screening using faecal occult blood testing: analysis of prevalence and incidence screening Steele, R. J. C. et al. BMJ 341, c5531 (2010)

A study has analyzed the uptake of fecal occult blood testing (FOBT), in Scottish adults aged 50–69 years. For prevalence screening, uptake was 53% for the first invitation, but interestingly 15% and 12% agreed to testing after receiving a second and third invitation, respectively. The results for incidence screening were more marked with 54% responding positively to the first invitation and a surprising 86% agreeing to screening after receiving a second invite. These results, and the fact that the positive predictive value of FOBT has been previously shown, indicate that the policy of sending repeat invitations is correct.