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Nutzen und Risiken des Mammographiescreenings

Benefits and risks of mammography screening

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Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Das Mammographiescreening wird z. T. in der Öffentlichkeit infrage gestellt.

Ziel

Vor- und Nachteile einer Teilnahme am Mammographiescreening werden dargestellt.

Material und Methode

Es erfolgte eine Auswertung internationaler Primärliteratur, Übersichtsarbeiten und Stellungnahmen von Expertengruppen.

Ergebnisse

Die etablierten Mammographiescreening-Programme erreichen oder übertreffen bezüglich Mortalitätssenkung die Ergebnisse der zugrunde gelegten randomisierten Studien. Dem Nutzen der Teilnahme müssen Nachteile wie Überdiagnosen und falsch-positive Verdachtsbefunde gegenübergestellt werden, die jedem Früherkennungsprogramm inhärent sind. Die quantitative Bewertung der Vor- und Nachteile erfordert einen hoch entwickelten epidemiologischen Sachverstand. Die große Mehrzahl der qualifizierten Expertengremien empfiehlt das Mammographiescreening für die Altersgruppe 50–70 Jahre. Die Ablehnung beruht z. T. auf falschen oder unvollständigen Analysen der Studien.

Schlussfolgerung

Die Teilnahme am Mammographiescreening kann den Frauen der entsprechenden Altersgruppe empfohlen werden. Die einzelne Teilnehmerin sollte möglichst in die Lage versetzt werden, eine Entscheidung zur Teilnahme auf Grundlage der Ergebnisse der Programme und ihrer eigenen Präferenzen zu treffen.

Abstract

Background

Mammography screening is partly being questioned in public.

Objective

Description of advantages and disadvantages of participation in mammography screening programs.

Material and methods

Analysis of international primary literature, reviews and statements of expert panels.

Results

Concerning the reduction of breast cancer mortality, the established mammography screening programs achieve or surpass the results of the randomized studies on which they were based. Disadvantages, such as overdiagnosis and false positive suspicious findings, which are inherent to any early detection program, have to be balanced against this advantage. The quantitative assessment of these advantages and disadvantages requires a high level of epidemiological expertise. The majority of qualified expert panels recommend mammography screening for the age group 50–70 years. Rejection partially results from incomplete or inadequate analysis of the studies.

Conclusion

Participation in mammography screening programs can be recommended for women in the appropriate age group. Individual women should be placed in a position to be able to decide on participation on the basis of the results of the programs and own preferences as much as possible.

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Authors and Affiliations

  1. Universitätsfrauenklinik Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Deutschland

    Hans Junkermann

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  1. Hans Junkermann
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Correspondence to Hans Junkermann.

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Interessenkonflikt

H. Junkermann ist als Befunder im Mammographiescreening tätig.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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Junkermann, H. Nutzen und Risiken des Mammographiescreenings. Onkologe 23, 422–428 (2017). https://doi.org/10.1007/s00761-017-0204-z

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  • DOI: https://doi.org/10.1007/s00761-017-0204-z

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