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Systematic review
Mammography reduces breast cancer mortality in women aged 39–69 years; but harms may outweigh benefits in women under 50
  1. Karsten Juhl Jørgensen
  1. Correspondence to Karsten Juhl Jørgensen
    The Nordic Cochrane Centre, Rigshospitalet, Department 3343, Blegdamsvej 9, 2100 Copenhagen, Denmark; kj{at}

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This is an update of a 2002 review and includes a new randomised controlled trial (RCT) of mammography screening for women in their 40s. It now also assesses clinical breast examination (CBE) and regular breast self-examination (BSE) and forms part of the basis for US Preventive Services Task Force recommendations.1

The review includes RCTs and systematic reviews for the outcome ‘breast cancer mortality’. The Cochrane Library and MEDLINE were the primary databases. When quantifying harms, the review used less reliable study designs. Primary data on breast cancer from the USA were also used.

For women aged 39–49 years, the pooled estimate from eight RCTs of mammography screening was a RR of 0.85 (95% CI 0.75 to 0.96). There was no reduction in breast cancer mortality in women aged >70 years (RR 1.12; CI 0.73 to 1.72, but only one RCT). …

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  • Competing interests None.