Screening Trial for Breast Cancer in China

Breast cancer is by far the most common female cancer (21.6/100,000) and one of the primary causes of death (5.7/100,000) among Chinese women, with an estimated 169,452 new cases and 44,908 deaths in 2008 1. The total annual number of new cases in regions with limited health resources continues to increase 1,2. The causes of breast cancer remain unclear. Early detection is believed to be the best means of reducing mortality and improving postoperative quality of life for patients with breast cancer 3. Mammography (mam) is the only evidence-based screening technology available for that purpose, as verified by randomized clinical trials in Western countries 4. Although organizations have released conflicting recommendations on the risks and benefits of mam in clinical and societal contexts 5, many Western countries have successfully implemented mass mam screening for breast cancer 6. However, evidence to justify population-based breast cancer screening by mam for women in China is currently lacking. To date, no randomized controlled trials of mam screening have been conducted among Chinese women, and evidence that such screening would reduce breast cancer mortality in China is insufficient. One disadvantage of mam is its limitations in detecting small lumps in dense breast tissue, because the dense parenchyma in women before menopause can obscure tumour shadows 7,8. Dense parenchyma is common in Chinese women 9. Additionally, mass mam screening in China would likely not be cost effective. Wong and colleagues 10 developed a Markov model to simulate mam screening, breast cancer ABSTRACT