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Screening

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Handbook of Epidemiology

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Abstract

Screening, sometimes termed “secondary prevention,” is one of the major components of disease control. It is particularly relevant for the control of cancers such as breast, cervical, and colorectal cancer. While there was partly the belief that screening is always advantageous, the complexity of population screening is now well recognized, as is the need for carefully balancing the benefits, harms and risks of screening. This chapter will address the general principles governing the introduction of screening, the ethics of screening, the population to be included in screening, the evaluation of the efficacy of screening, as well as several aspects related to population-based screening programs.

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References

  • Andriole GL, Grubb RL, Buys SS, Chia D, Church TR, Fouad MN, Gelmann EP, Kvale PA, Reding DJ, Weissfeld JL, Yokochi LA, Crawford ED, O’Brien B, Clapp JD, Rathmell JM, Riley TL, Hayes RB, Kramer BS, Izmirlian G, Miller AB, Pinsky PF, Prorok PC, Gohagan JK, Berg CD, for the PLCO Project Team (2009) Mortality results from a randomized prostate-cancer screening trial. New Eng J Med 360:1310–1319

    Article  CAS  PubMed  Google Scholar 

  • Baines CJ, McFarlane DV, Miller AB (1988) Sensitivity and specificity for first screen mammography in 15 NBSS centres. J Can Assoc Rad 39:273–276

    CAS  Google Scholar 

  • Baines CJ, Miller AB, Bassett AA (1989) Physical examination. Evaluation of its role as a single screening modality in the Canadian National Breast Screening Study. Cancer 63:160–166

    Google Scholar 

  • Beahrs OH, Shapiro S, Smart C (1979) Report of the working group to review the National Cancer Institute, American Cancer Society breast cancer detection demonstration projects. J Natl Cancer Inst 62:640–709

    Google Scholar 

  • Bernal JL, Cummins S, Gasparrini A (2017) Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol 46:348–355

    PubMed  Google Scholar 

  • Bhatla N, Singhal S (2020) Primary HPV screening for cervical cancer. Best Pract Res Clin Obstet Gynaecol 65:98–108

    Article  PubMed  Google Scholar 

  • Biesheuvel C, Barratt A, Howard K, Houssami N, Irwig L (2007) Effects of study methods and biases on estimates of invasive breast cancer overdetection with mammography screening: a systematic review. Lancet Oncol 8:1129–1138

    Article  PubMed  Google Scholar 

  • Boyd NF, Wolfson C, Moskowitz M, Carlile T, Petitclerc M, Ferri HA, Fishell E, Gregoire A, Kiernan M, Longley JD, Simor IS, Miller AB (1982) Observer variation in the interpretation of Xeromammograms. J Natl Cancer Inst 68:357–363

    CAS  PubMed  Google Scholar 

  • Boyes DA, Morrison B, Knox EG, Draper GJ, Miller AB (1982) A cohort study of cervical cancer in British Columbia. Clin Invest Med 5:1–29

    CAS  PubMed  Google Scholar 

  • Braitmaier M, Schwarz S, Kollhorst B, Senore C, Didelez V, Haug U (2022) Screening colonoscopy similarly prevented distal and proximal colorectal cancer: a prospective study among 55-69-year-olds. J Clin Epidemiol 149:118–126

    Article  PubMed  Google Scholar 

  • Brookmeyer R, Day NE, Moss S (1986) Case-control studies for estimation of the natural history of preclinical disease from screening data. Stat Med 5:127–138

    Article  CAS  PubMed  Google Scholar 

  • Chodak GW, Schoenberg HW (1989) Progress and problems in screening for carcinoma of the prostate. World J Surg 13:60–64

    Article  CAS  PubMed  Google Scholar 

  • Commission on Chronic Illness (1957) Chronic illness in the United States: prevention of chronic illness. Harvard University Press, Cambridge

    Book  Google Scholar 

  • Cuckle HS, Wald NJ (1984) Principles of screening. In: Wald NY (ed) Antenatal and neonatal screening. Oxford University Press, Oxford

    Google Scholar 

  • Day NE (1985) Estimating the sensitivity of a screening test. J Epidemiol Community Health 39:364–366

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Day NE, Williams DRR, Khaw KT (1989) Breast cancer screening programmes: the development of a monitoring and evaluation system. Br J Cancer 59:954–958

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dobrow MJ, Hagens V, Chafe R, Sullivan T, Rabeneck L (2018) Consolidated principles for screening based on a systematic review and consensus process. CMAJ 190:E422–e429

    Article  PubMed  PubMed Central  Google Scholar 

  • Duffy SW, Agbaje O, Tabar L, Vitak B, Bjurstam N, Björneld L, Myles JP, Warwick J (2005) Overdiagnosis and overtreatment of breast cancer: estimates of overdiagnosis from two trials of mammographic screening for breast cancer. Breast Cancer Res 7:258–265

    Article  PubMed  PubMed Central  Google Scholar 

  • Elmunzer BJ, Hayward RA, Schoenfeld PS, Saini SD, Deshpande A, Waljee AK (2012) Effect of flexible sigmoidoscopy-based screening on incidence and mortality of colorectal cancer: a systematic review and meta-analysis of randomized controlled trials. PLoS Med 9:e1001352

    Article  PubMed  PubMed Central  Google Scholar 

  • European Society for Mastology (1993) Report of the European Society for Mastology Breast Cancer Screening Evaluation Committee. Consensus conference on breast cancer screening. European Society for Mastology

    Google Scholar 

  • Fenton JJ, Weyrich MS, Durbin S, Liu Y, Bang H, Melnikow J (2018) Prostate-specific antigen-based screening for prostate cancer: a systematic evidence review for the U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality (US), Rockville (MD)

    Google Scholar 

  • Force T (1976) Cervical cancer screening programs. The Walton report. Can Med Assoc J 114:1003–1033

    Google Scholar 

  • García-Albéniz X, Hsu J, Bretthauer M, Hernán MA (2017a) Effectiveness of screening colonoscopy to prevent colorectal cancer among Medicare beneficiaries aged 70 to 79 years: a prospective observational study. Ann Intern Med 166:18–26

    Article  PubMed  Google Scholar 

  • García-Albéniz X, Hsu J, Hernán MA (2017b) The value of explicitly emulating a target trial when using real world evidence: an application to colorectal cancer screening. Eur J Epidemiol 32:495–500

    Article  PubMed  PubMed Central  Google Scholar 

  • García-Albéniz X, Hernán MA, Logan RW, Price M, Armstrong K, Hsu J (2020) Continuation of annual screening mammography and breast cancer mortality in women older than 70 years. Ann Intern Med 172:381–389

    Article  PubMed  Google Scholar 

  • Gastrin G, Miller AB, To T, Aronson KJ, Wall C, Hakama M, Louhivuori K, Pukkala E (1994) Incidence and mortality from breast cancer in the Mama program for breast screening in Finland, 1973–1986. Cancer 73:2168–2174

    Article  CAS  PubMed  Google Scholar 

  • Geurts SME, Aarts A, Verbeek ALM, Chen THH, Broeders MJM, Duffy SW (2022) Quantifying the duration of the preclinical detectable phase in cancer screening: a systematic review. Epidemiol Health 44:e2022008

    Article  PubMed  PubMed Central  Google Scholar 

  • Goin JE, Haberman JD (1982) Comments on the logistic function in ROC analysis: applications to breast cancer detection. Method Inf Med 21:26–30

    Article  CAS  Google Scholar 

  • Hakama M (1982) Trends in the incidence of cervical cancer in the Nordic countries. In: Magnus K (ed) Trends in cancer incidence. Hemisphere Publishing, Washington, pp 279–292

    Google Scholar 

  • Hakama M (1984) Selective screening by risk groups. In: Prorok PC, Miller AB (eds) Screening for cancer, UICC technical report series, vol 78. International Union Against Cancer, Geneva, pp 71–79

    Google Scholar 

  • Hakama M, Chamberlain J, Day NE, Miller AB, Prorok PC (1985) Evaluation of screening programmes for gynaecological cancer. Br J Cancer 52:669–673

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hakama M, Auvinen A, Day NE, Miller AB (2007) Sensitivity in cancer screening. J Med Screen 14:74–77

    Article  Google Scholar 

  • Hoffman RM, Atallah RP, Struble RD, Badgett RG (2020) Lung cancer screening with low-dose CT: a meta-analysis. J Gen Intern Med 35:3015–3025

    Article  PubMed  PubMed Central  Google Scholar 

  • Hol L, van Leerdam ME, van Ballegooijen M, van Vuuren AJ, van Dekken H, Reijerink JC, van der Togt AC, Habbema JD, Kuipers EJ (2010) Screening for colorectal cancer: randomised trial comparing guaiac-based and immunochemical faecal occult blood testing and flexible sigmoidoscopy. Gut 59:62–68

    Article  CAS  PubMed  Google Scholar 

  • Holowaty P, Miller AB, Rohan T, To T (1999) The natural history of dysplasia of the uterine cervix. J Natl Cancer Inst 91:252–258

    Article  CAS  PubMed  Google Scholar 

  • Howard J (1987) Using mammography for cancer control: an unrealized potential. Cancer 37:33–48

    CAS  Google Scholar 

  • Howlett RI, Miller AB, Pasut G, Mai V (2009) Defining a strategy to evaluate cervical cancer prevention and early detection in the era of HPV vaccination. Prev Med 48:432. https://doi.org/10.1016/j.ypmed.2008.12.022

    Article  PubMed  Google Scholar 

  • IARC (2002) Breast cancer screening. IARC handbooks on cancer prevention, vol 8. International Agency for Research on Cancer, Lyon

    Google Scholar 

  • Independent UK Panel on Breast Cancer Screening (2012) The benefits and harms of breast cancer screening: an independent review. Lancet 380:1778–1786

    Article  Google Scholar 

  • Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (2022) Überprüfung der Altersgrenzen im Mammografie-Screening-Programm. IQWiG-Berichte – Nr 1383 Last Update 16 Aug 2022. https://www.iqwig.de/projekte/s21-01.html. Accessed 16 Aug 2022

  • Jørgensen KJ, Gøtzsche PC (2009) Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends. BMJ 339:b2587

    Article  PubMed  PubMed Central  Google Scholar 

  • Krahn MD, Mahoney JE, Eckman MH, Trachtenberg J, Pauker SG, Detsky AS (1994) Screening for prostate cancer: a decision analytic view. JAMA 272:781–786

    Article  Google Scholar 

  • Lansdorp-Vogelaar I, Knudsen AB, Brenner H (2010) Cost-effectiveness of colorectal cancer screening – an overview. Best Pract Res Clin Gastroenterol 24:439–449

    Article  PubMed  PubMed Central  Google Scholar 

  • Lansdorp-Vogelaar I, Meester R, de Jonge L, Buron A, Haug U, Senore C (2022) Risk-stratified strategies in population screening for colorectal cancer. Int J Cancer 150:397–405

    Article  CAS  PubMed  Google Scholar 

  • Lauby-Secretan B, Vilahur N, Bianchini F, Guha N, Straif K (2018) The IARC perspective on colorectal cancer screening. N Engl J Med 378:1734–1740

    Article  PubMed  PubMed Central  Google Scholar 

  • Mandal R, Basu P (2018) Cancer screening and early diagnosis in low and middle income countries: current situation and future perspectives. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 61:1505–1512

    Article  PubMed  Google Scholar 

  • Marrett LD, Robles S, Ashbury FD, Green B, Goel V, Luciani S (2002) A proposal for cervical screening information systems in develo** countries. Int J Cancer 102:293–299

    Article  CAS  PubMed  Google Scholar 

  • McGeoch L, Saunders CL, Griffin SJ, Emery JD, Walter FM, Thompson DJ, Antoniou AC, Usher-Smith JA (2019) Risk prediction models for colorectal cancer incorporating common genetic variants: a systematic review. Cancer Epidemiol Biomark Prev 28:1580–1593

    Article  Google Scholar 

  • McLelland R, Pisano ED (1992) The politics of mammography. Radiol Clin N Am 30:235–241

    Article  CAS  PubMed  Google Scholar 

  • Miller AB (ed) (1978) Screening in cancer. A report of the UICC international workshop in Toronto, UICC technical report series, vol, vol 40. International Union Against Cancer, Geneva

    Google Scholar 

  • Miller AB (1981) An evaluation of population screening for cervical cancer. In: Koss LG, Coleman DV (eds) Advances in clinical cytology. Butterworths, London, pp 64–94

    Chapter  Google Scholar 

  • Miller AB (1987) Early detection of breast cancer. In: Harris JR, Henderson IC, Hellman S, Kinne DW (eds) Breast diseases. Lippincott, Philadelphia, pp 122–134

    Google Scholar 

  • Miller AB (1991) Issues in screening for prostate cancer. In: Miller AB, Chamberlain J, Day NE, Hakama M, Prorok PC (eds) Cancer screening. Cambridge University Press, Cambridge, pp 289–293

    Google Scholar 

  • Miller AB (1994) Screening for cancer: is it time for a paradigm shift? Ann R Coll Physician Surg Can 27:353–355

    Google Scholar 

  • Miller AB (1996) Fundamental issues in screening for cancer. In: Schottenfeld D, Fraumeni JF Jr (eds) Cancer epidemiology and prevention, 2nd edn. Oxford University Press, New York/Oxford, pp 1433–1452

    Google Scholar 

  • Miller AB, Tsechkovski M (1987) Imaging technologies in breast cancer control: summary report of a world health organization meeting. AJR 148:1093–1094

    Google Scholar 

  • Miller AB, Lindsay J, Hill GB (1976) Mortality from cancer of the uterus in Canada and its relationship to screening for cancer of the cervix. Int J Cancer 17:602–612

    Article  CAS  PubMed  Google Scholar 

  • Miller AB, Chamberlain J, Day NE, Hakama M, Prorok PC (1990) Report on a workshop of the UICC project on evaluation of screening for cancer. Int J Cancer 46:761–769

    Article  CAS  PubMed  Google Scholar 

  • Miller AB, Anderson G, Brisson J, Laidlaw J, Le Pitre N, Malcolmson P, Mirwaldt P, Stuart G, Sullivan W (1991) Report of a national workshop on screening for cancer of the cervix. Can Med Assoc J 145:1301–1325

    CAS  Google Scholar 

  • Miller AB, Baines CJ, To T, Wall C (1992) Canadian national breast screening study: 2. Breast cancer detection and death rates among women age 50–59 years. Can Med Assoc J 147:1477–1488

    CAS  Google Scholar 

  • Miller AB, Nazeer S, Fonn S, Brandup-Lukanow A, Rehman R, Cronje H, Sankaranarayanan R, Koroltchouk V, Syrjanen K, Singer A, Onsrud M (2000a) Report on consensus conference on cervical cancer screening and management. Int J Cancer 86:440–447

    Article  CAS  PubMed  Google Scholar 

  • Miller AB, To T, Baines CJ, Wall C (2000b) Canadian National Breast Screening Study-2: 13-year results of a randomized trial in women age 50–59 years. J Natl Cancer Inst 92:1490–1499

    Article  CAS  PubMed  Google Scholar 

  • Miller AB, Madalinska JB, Church T, Crawford D, Essink-Bot ML, Goel V, de Koning HJ, Maatanem L, Pentikainen T (2001) Review: health-related quality of life and cost-effectiveness studies in the European randomised study of screening for prostate cancer and the U.S. Prostate, Lung, Colon and Ovary trial. Eur J Cancer 37:2154–2160

    Article  CAS  PubMed  Google Scholar 

  • Miller AB, To T, Baines CJ, Wall C (2002) The Canadian National Breast Screening Study-1: breast cancer mortality after 11 to 16 years of follow-up. A randomized screening trial of mammography in women age 40 to 49 years. Ann Intern Med 137:305–312

    Article  PubMed  Google Scholar 

  • Morrell S, Barratt A, Irwig L, Howard K, Biesheuvel C, Armstrong B (2010) Estimates of overdiagnosis of invasive breast cancer associated with screening mammography. Cancer Causes Control 21:275–282

    Article  PubMed  Google Scholar 

  • Morrison AS (1985) Screening in chronic disease. Oxford University Press, Oxford, pp 48–63

    Google Scholar 

  • Morrison AS, Brisson J, Khalid N (1988) Breast cancer incidence and mortality in the breast cancer detection demonstration project. J Natl Cancer Inst 80:1540–1547

    Article  CAS  PubMed  Google Scholar 

  • Moskowitz M, Pemmaraju S, Fidler JA, Sutorius DJ, Russell P, Scheinok P, Holle J (1976) On the diagnosis of minimal breast cancer in a screenee population. Cancer 37:2543–2552

    Article  CAS  PubMed  Google Scholar 

  • Moss SM (1991) Case-control studies of screening. Int J Epidemiol 20:1–6

    Article  CAS  PubMed  Google Scholar 

  • Moss S, Draper GJ, Hardcastle JD, Chamberlain J (1987) Calculation of sample size in trials of screening for early diagnosis of disease. Int J Epidemiol 16:104–110

    Article  CAS  PubMed  Google Scholar 

  • Moss SM, Cuckle H, Evans A, Johns L, Waller M, Bobrow L, Trial Management Group (2006) Effect of mammographic screening from age 40 years on breast cancer mortality at 10 years’ follow-up: a randomised controlled trial. Lancet 368:2053–2060

    Article  PubMed  Google Scholar 

  • Nieminen P, Kallio M, Anttila A, Hakama M (1999) Organised vs. spontaneous pap-smear screening for cervical cancer: a case-control study. Int J Cancer 83:55–58

    Article  CAS  PubMed  Google Scholar 

  • Prorok PC, Chamberlain J, Day NE, Hakama M, Miller AB (1984) UICC workshop on the evaluation of screening programmes for cancer. Int J Cancer 34:1–4

    Article  CAS  PubMed  Google Scholar 

  • Puliti D, Duffy SW, Miccinesi G, de Koning H, Lynge E, Zappa M, Paci E (2012) Overdiagnosis in mammographic screening for breast cancer in Europe: a literature review. J Med Screen 19(Suppl 1):42–56

    Article  PubMed  Google Scholar 

  • Sasco AJ, Day NE, Walter SD (1986) Case-control studies for the evaluation of screening. J Chronic Dis 39:399–405

    Article  CAS  PubMed  Google Scholar 

  • Schechter MT, Miller AB, Baines CJ, Howe GR (1986) Selection of women at high risk of breast cancer for initial screening. J Chronic Dis 39:253–260

    Article  CAS  PubMed  Google Scholar 

  • Siu AL, U.S. Preventive Services Task Force (2016) Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 164:279–296

    Article  PubMed  Google Scholar 

  • Strong K, Wald N, Miller A, Alwan A, on behalf of the WHO Consultation Group (2005) Current concepts in screening for noncommunicable disease: World Health Organization Consultation Group report on methodology of noncommunicable disease screening. J Med Screen 12:12–19

    Article  CAS  PubMed  Google Scholar 

  • Swets JA (1979) ROC analysis applied to the evaluation of medical imaging technologies. Investig Radiol 14:109–121

    Article  CAS  Google Scholar 

  • Tabar L, Fagerberg CJG, Gad A, Baldetorp L, Holmberg LH, Gröntoft O, Ljungquist U, Lundstrm B, Månson JC, Eklund G, Day NE (1985) Reduction in mortality from breast cancer after mass screening with mammography: randomized trial from the breast cancer screening working group of the Swedish National Board of Health and Welfare. Lancet 1:829–832

    Article  CAS  PubMed  Google Scholar 

  • Tabar L, Fagerberg G, Duffy SW, Day NE (1989) The Swedish two county trial of mammographic screening for breast cancer: recent results and calculation of benefit. J Epidemiol Community Health 43:107–114

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Toes-Zoutendijk E, van Leerdam ME, Dekker E, van Hees F, Penning C, Nagtegaal I, van der Meulen MP, van Vuuren AJ, Kuipers EJ, Bonfrer JMG, Biermann K, Thomeer MGJ, van Veldhuizen H, Kroep S, van Ballegooijen M, Meijer GA, de Koning HJ, Spaander MCW, Lansdorp-Vogelaar I (2017) Real-time monitoring of results during first year of Dutch colorectal cancer screening program and optimization by altering fecal immunochemical test cut-off levels. Gastroenterology 152:767–775.e762

    Google Scholar 

  • UK Trial of Early Detection of Breast Cancer Group (1988) First results on mortality reduction in the UK Trial of Early Detection of Breast Cancer. Lancet ii:411–416

    Google Scholar 

  • Walter SD, Day NE (1983) Estimation of the duration of a pre-clinical disease state using screening data. Am J Epidemiol 118:865–886

    Article  CAS  PubMed  Google Scholar 

  • Walter SD, Stitt LW (1987) Evaluating the survival of cancer cases detected by screening. Stat Med 6:885–900

    Article  CAS  PubMed  Google Scholar 

  • Weiss NS (1983) Control definition in case-control studies of the efficacy of screening and diagnostic testing. Am J Epidemiol 116:457–460

    Google Scholar 

  • Weiss CH (1998) Evaluation. Prentice Hall, Englewood Cliffs

    Google Scholar 

  • Wilson JMG, Junger G (1968) Principles and practice of screening for disease. World Health Organization, Geneva

    Google Scholar 

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Authors and Affiliations

  1. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Anthony B. Miller

  2. Klinische Epidemiologie, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany

    Ulrike Haug

  3. Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany

    Ulrike Haug

Authors
  1. Anthony B. Miller
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  2. Ulrike Haug
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Correspondence to Ulrike Haug .

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Editors and Affiliations

  1. Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen, Germany

    Wolfgang Ahrens

  2. Bremer Institut für Präventionsforschung und Sozialmedizin (BIPS), Bremen, Germany

    Iris Pigeot

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Miller, A.B., Haug, U. (2023). Screening. In: Ahrens, W., Pigeot, I. (eds) Handbook of Epidemiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6625-3_32-1

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  • DOI: https://doi.org/10.1007/978-1-4614-6625-3_32-1

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