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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 Womena Reduction in Breast Cancer Mortality (vs. No Screening), by Modelb
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 29c 35 54
Borderline strategies (dominated in 2-3 of 6 models)
Biennial screening, ages 40-79 y 17,241 27d 35 26 26d 25d 36
Annual screening, ages 50-79 y 24,419 32 39 27d 26d 30 42
Annual screening, ages 50-84 y 26,905 35 41 28d 28d 33 45
Annual screening, ages 40-79 y 34,078 34d 46 30 27d 33d 51
Inefficient/dominated strategies (dominated in all 6 models)
Annual screening, ages 60-69 y 8,438 14d 18d 13d 12d 12d 17d
Biennial screening, ages 45-69 y 11,694 18d 26d 20d 19d 17d 27d
Annual screening, ages 55-69 y 13,009 18d 25d 17d 15d 16d 26d
Biennial screening, ages 40-69 y13,831 18d 28d 20d 19d 16d 29d
Annual screening, ages 50-69 y 17,733 21d 31d 20d 18d 20d 33d
Annual screening, ages 50-74 y 21,330 27d 35d 24d 22d 26d 38d
Annual screening, ages 45-69 y 22,546 23d 35d 22d 20d 22d 39d
Annual screening, ages 40-69 y 27,428 24d 39d 23d 20d 22d 43d

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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