Efficacy of mammography screening in women aged 40–49 years: An updated systematic review and meta-analysis.

Abstract

e22513 Background: The screening of women aged over 50 through mammography has proven to significantly reduce breast cancer mortality in randomized controlled trials (RCTs). Despite prior trials and meta-analyses, new trials have been published and debates persist regarding the effectiveness of mammography screening for women aged 40–49. Therefore, we conducted an updated meta-analysis to assess the impact of mammography screening on reducing breast cancer mortality within this age group. Methods: In adherence to PRISMA guidelines, we systematically searched Pubmed, Cochrane, and Embase libraries for RCTs evaluating the efficacy of mammography screening in lowering breast cancer mortality among patients aged 40–49. Exclusion criteria encompassed non-RCTs, studies lacking reports on breast cancer mortality for individuals aged 40–49, and secondary analyses of included trials. Data extraction was carried out based on the latest available follow-up. We synthesized the relative risk (RR) for breast cancer mortality along with their corresponding 95% confidence intervals (95% CI). Employing a random-effects model, statistical analysis was conducted using RevMan 5.4 version, with an evaluation of I2 statistics for heterogeneity. Results: From 797 initial studies, 10 RCTs were included, comprising 163,634 women in the intervention group and 206,130 in the control group. Median follow-up ranged from 14 to 30 years. In individual studies, statistical significance was only reached in one trial (Table). Breast cancer mortality in the intervention group was significantly lower than in the control group RR 0.86 [95% CI 0.77–0.95]; p = 0.004; I2 = 0%. Conclusions: Despite limited data availability for this age group in certain recent publications with extended follow-up periods, raised questions about the design and reported results in some trials, the comprehensive findings of this meta-analysis suggest that mammography screening retains its effectiveness in reducing breast cancer mortality among women aged 40–49 years. [Table: see text]