skip navigation

Key Publications in Cancer Control

Study Examples | Key Publications | Intro

Several key publications are listed below:

This cross-sectional analysis of more than 500 women diagnosed with invasive breast cancer related breast density to tumor size, lymph node involvement, and lymphatic or vascular invasion in screen-detected cancers. Further research should pursue whether these associations stem from a biological relationship, or from the fact that dense breast tissue hinders mammogram interpretation, or from both.

—Aiello EJ, Buist DS, White E, Porter PL (2005) Association between mammographic breast density and breast cancer tumor characteristics. Cancer Epidemiology, Biomarkers and Prevention, 14 (3): 662–668.

Top

Diagnostic tests such as mammography are often evaluated by comparing their outcome to the patient's true disease state; but two complications may interfere: verification bias (the probability of detecting disease may depend on both the test result and the subject’s characteristics); and intrareader correlation (tests interpreted by the same rater may not be independent). This paper suggests that in the context of an observational cohort study where rich covariate information is available, a weighted estimating equations approach may be the best way to address these complications.

—Zheng YY, Barlow WE, Cutter G (2005). Assessing accuracy of mammography in the presence of verification bias and intrareader correlation. Biometrics, 61: 259–268.

Top

Radiologists differ in their ability to interpret screening mammograms accurately. Raising volume requirements has been proposed as a way to improve mammography performance. This study investigated the relationship of radiologist characteristics to actual performance. Greater volume or experience at interpreting mammograms was not associated with better performance. However, volume and experience may affect sensitivity and specificity, possibly by determining the threshold for calling a mammogram positive. Increasing volume requirements is unlikely to improve overall mammography performance.

—Barlow WE, Chi C, Carney PA, Taplin SH, D'Orsi C, Cutter G, Hendrick RE, Elmore JG (2004). Accuracy of screening mammography interpretation by characteristics of radiologists. Journal of the National Cancer Institute, 96: 1840–1850.

Top

The study assessed whether the use of statins altered the risk of breast carcinoma in older women by comparing 975 women with breast cancer to 1,007 women without breast cancer. Compared with nonusers, women who were currently using statins or had ever used statins were not at increased risk for breast carcinoma; however this area warrants further confirmatory study.

—Boudreau DM, Gardner JS, Malone KE, Heckbert SR, Blough DK, Daling JR (2004). The association between 3-hydroxy-3-methylglutaryl coenzyme A inhibitor use and breast carcinoma risk among postmenopausal women: a case-control study. Cancer, 100 (11): 2308–2316.

Top

Greater breast density largely explains decreased mammography sensitivity in younger women looking at cancers occurring within 12 months, this study found. By contrast, rapid tumor growth and density largely explain decreased mammography sensitivity at 24 months. More frequent mammographic screening in younger women may alleviate the adverse impact of faster-growing tumors on mammographic sensitivity.

—Buist DSM, Porter PL, Lehman C, Taplin SH, White E (2004). Factors contributing to mammography failure in women aged 40-49 years. Journal of the National Cancer Institute, 96: 1432-1440.

Top

By medical consensus, average-risk adults should be screened for colorectal cancer (CRC) starting at age 50. Health plans have the ability to provide organizational infrastructure for a broad range of preventive services to well-defined populations. However, this study of a national sample of 180 health plans found that, as of 1999–2000, few had all three essential components of CRC screening delivery (coverage, guidelines, and tracking systems) in place.

—Klabunde CN, Riley GF, Mandelson MT, Frame PS, Brown ML (2004). Health plan policies and programs for colorectal cancer screening: a national profile. American Journal of Managed Care, 10 (4): 273–279.

Top

Breast augmentation is not associated with an increased risk of breast cancer. However, implants may interfere with the detection of breast cancer, and that can delay cancer diagnosis. This study reviewed mammography accuracy and tumor characteristics in women with and without augmentation. Although breast augmentation decreases the sensitivity of screening mammography among asymptomatic women, it does not increase the false-positive rate.

—Miglioretti DL, Rutter CM, Geller BM, Cutter G, Barlow WE, Rosenberg R, Weaver DL, Taplin SH, Ballard-Barbash R, Carney PA, Yankaskas BC, Kerlikowske K (2004). The effect of breast augmentation on the accuracy of mammography screening and cancer characteristics. Journal of the American Medical Association, 291 (4): 442–450.

Top

Breast density, which decreases with age and increases with hormone replacement therapy (HRT) use, is known to hinder mammogram interpretation. In this prospective cohort study of seven population-based mammography registries comprising more than 300,000 women, breast density and age predicted the accuracy (adjusted sensitivity and specificity) of screening mammography. HRT use, although not an independent predictor of accuracy, likely affects accuracy by making breast tissue denser.

—Carney PA, Miglioretti DL, Yankaskas BC, Kerlikowske K, Rosenberg R, Rutter C, Geller BM, Abraham LA, Taplin, SH, Dignan M, Cutter G, Ballard-Barbash R (2003). Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography. Annals of Internal Medicine, 138 (3): 168–175.

Study Examples | Key Publications | Intro

Top