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Deutsches Ärzteblatt International
Article . 2018 . Peer-reviewed
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The Impact of Cancer Screening on All-Cause Mortality

Authors: Andreas, Stang; Karl-Heinz, Jöckel;

The Impact of Cancer Screening on All-Cause Mortality

Abstract

It is a matter of debate whether, and if so, to what extent, cancer screening programs reduce all-cause mortality. Against this backdrop, we analyzed potential effects of several cancer screening approaches on all-cause mortality in two representative Western European populations.We used mortality data from the UK (England &Wales) and Germany from 2015 and published figures from screening studies on relative reduction in mortality for screened cancers to calculate the expected decline in all-cause mortality in these countries. We determined the required sample size for demonstrating a 3% reduction in all-cause mortality with a narrow (95%) confidence interval in a hypothetical screening trial.A relative 20% reduction in breast cancer mortality can be accompanied by a maximum 1.7-1.8% reduction in all-cause mortality in England & Wales and Germany, respectively. Expected declines are smaller for sigmoidoscopy screening (1.0-1.2%), prostate-specific antigen (PSA) screening (0.4-0.6%), and skin cancer screening (0.2%). To obtain a 95% confidence interval of +/-1% for demonstrating a 3% decline in all-cause mortality, a study size of 596 200 persons is required.Because the proportion of cancer deaths in all deaths in Western Europe is relatively low, cancer screening procedures can reduce all-cause mortality by only 1-3%. However, this reduction is relevant to public health.

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Keywords

Cause of Death, Germany, Neoplasms, Age Factors, Humans, Health Promotion, Early Detection of Cancer, United Kingdom

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    selected citations
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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    19
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
19
Top 10%
Top 10%
Top 10%
gold
Related to Research communities
Cancer Research