Effects of Mammography Screening Under Different Screening Schedules: Model Estimates of Potential Benefits and Harms

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Appendix Table 3. Average Number of Screening Examinations and Percentage of Reduction in Breast Cancer Mortality, by Screening Strategy

Screening Strategy	Average Screenings per 1000 Women^a	Reduction in Breast Cancer Mortality (vs. No Screening), by Model^b
Screening Strategy	Average Screenings per 1000 Women^a	D	E	G	M	S	W
Efficient strategies (not dominated in 6 of 6 models)
Biennial screening, ages 60-69 y	4,263	11	13	11	10	9	12
Biennial screening, ages 55-69 y	6,890	15	18	15	14	13	19
Biennial screening, ages 50-69 y	8,947	16	23	17	16	15	23
Biennial screening, ages 50-74 y	11,066	22	27	21	21	20	28
Biennial screening, ages 50-79 y	12,366	25	29	24	24	25	30
Biennial screening, ages 50-84 y	13,837	29	31	25	27	26	33
Biennial screening, ages 40-84 y	18,708	31	37	28	29	27	39
Annual screening, ages 50-84 y	36,550	38	49	32	29^c	35	54
Borderline strategies (dominated in 2-3 of 6 models)
Biennial screening, ages 40-79 y	17,241	27^d	35	26	26^d	25^d	36
Annual screening, ages 50-79 y	24,419	32	39	27^d	26^d	30	42
Annual screening, ages 50-84 y	26,905	35	41	28^d	28^d	33	45
Annual screening, ages 40-79 y	34,078	34^d	46	30	27^d	33^d	51
Inefficient/dominated strategies (dominated in all 6 models)
Annual screening, ages 60-69 y	8,438	14^d	18^d	13^d	12^d	12^d	17^d
Biennial screening, ages 45-69 y	11,694	18^d	26^d	20^d	19^d	17^d	27^d
Annual screening, ages 55-69 y	13,009	18^d	25^d	17^d	15^d	16^d	26^d
Biennial screening, ages 40-69 y	13,831	18^d	28^d	20^d	19^d	16^d	29^d
Annual screening, ages 50-69 y	17,733	21^d	31^d	20^d	18^d	20^d	33^d
Annual screening, ages 50-74 y	21,330	27^d	35^d	24^d	22^d	26^d	38^d
Annual screening, ages 45-69 y	22,546	23^d	35^d	22^d	20^d	22^d	39^d
Annual screening, ages 40-69 y	27,428	24^d	39^d	23^d	20^d	22^d	43^d

^a Average number of mammograms across models. Not all possible mammograms in the age group are obtained in strategies that continue to the oldest age groups, because many women die of other causes before screening would occur.
^b Model group abbreviations: D = Dana-Farber Cancer Institute; E = Erasmus Medical Center; G = Georgetown University; M = M.D. Anderson Cancer Center; S = Stanford University; W = University of Wisconsin/Harvard.
^c Because of rounding, this strategy seems to be dominated, but the actual result is 29.4.
^d Strategy is dominated ("inefficient") within the specific model. A strategy is classified as dominated if another strategy (from the efficient, borderline, or inefficient/dominated category) results in an equal or higher percentage of mortality reduction with fewer average screening examinations.

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