Breast cancer mortality and associated factors in São Paulo State, Brazil: an ecological analysis.
Carmen Simone Grilo DinizAlessandra Cristina Guedes PelliniAdeylson Guimarães RibeiroMarcello Vannucci TedardiMarina Jorge de MirandaMichelle Mosna TousoOswaldo Santos BaqueroPatrícia Carlos Dos SantosFrancisco Chiaravalotti NetoPublished in: BMJ open (2017)
The findings that mammography ratio was associated, in the municipal level, with increased mortality add to the evidence of a probable overestimation of benefits and underestimation of risks associated with this form of screening. The same paradoxical trend of increased mortality with screening was found in recent individual-level studies, indicating the need to expand informed choice for patients, primary prevention actions and individualised screening. Additional studies should be conducted to explore if there is a causality link in this association.
Keyphrases
- cardiovascular events
- end stage renal disease
- risk factors
- newly diagnosed
- ejection fraction
- chronic kidney disease
- peritoneal dialysis
- wastewater treatment
- case control
- prognostic factors
- coronary artery disease
- magnetic resonance imaging
- climate change
- patient reported outcomes
- decision making
- young adults
- contrast enhanced
- adverse drug
- image quality