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Article: Who receives, benefits from and is harmed by cervical and breast cancer screening among Hong Kong Chinese?

TitleWho receives, benefits from and is harmed by cervical and breast cancer screening among Hong Kong Chinese?
Authors
KeywordsBreast cancer
Cervical cancer
DALYs
Iatrogenesis
Screening
Issue Date2008
PublisherOxford University Press. The Journal's web site is located at http://jpubhealth.oxfordjournals.org/
Citation
Journal Of Public Health, 2008, v. 30 n. 3, p. 282-292 How to Cite?
AbstractBackground: To estimate the proportion of and characterize women who had received cervical and breast screening and to quantify the associated preventable burden of disease and potential iatrogenic harm. Methods: A total of 3484 Hong Kong Chinese women were interviewed in person. Screening prevalence and associated predictors, disability-adjusted life-years (DALYs), the numbers of false-positive tests and the resultant confirmatory procedures and related complications were estimated. Results: A total of 6.2% of women (≥18) reported regular pap but no mammography or clinical breast examination (CBE) as per local evidence-based guidelines, whereas among women aged ≥40 years, 5.2% reported regular screening by all three modalities and 55.3% had never been screened for either cancer. Women who underwent regular health checkups were consistently the most likely to have been screened, as were younger, married and socially advantaged respondents. Triennial pap screening would save 708 DALYs annually, or 528 more DALYs compared with the status quo. However, this would generate 28 600 repeat smears and 390 colposcopies from false-positive screens. Opportunistic mammographic screening averted 100 DALYs currently, but could have potentially reduced a further 546 with biennial screening. Mass screening mammography (CBE) would lead to 33 700 (20 200) false-positives per year requiring 29 900 (8300) repeat mammograms or ultrasonograms, 6800 (3000) biopsies and 620 (270) biopsy-related complications. Conclusions: Screening uptake patterns are suboptimal. By making explicit the possible risks and benefits based on this template, policy makers in developing Asia with a similar female cancer burden may be able to use the information to make evidence-based decisions that are consistent with local circumstances, values and preferences. © The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/60278
ISSN
2015 Impact Factor: 2.019
2015 SCImago Journal Rankings: 0.933
ISI Accession Number ID
Funding AgencyGrant Number
Hong Kong Special Administrative Government's Department of Health
Graduate School of the University of Hong Kong
Funding Information:

The fieldwork of the Population Health Survey 2003/4 is sponsored by the Hong Kong Special Administrative Government's Department of Health. PPSW thanks the Graduate School of the University of Hong Kong for financial support.

References

 

DC FieldValueLanguage
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorWoo, PPSen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorTsang, CSHen_HK
dc.contributor.authorCheung, ANYen_HK
dc.contributor.authorNgan, HYSen_HK
dc.contributor.authorGalbraith, Ken_HK
dc.contributor.authorLam, THen_HK
dc.date.accessioned2010-05-31T04:07:26Z-
dc.date.available2010-05-31T04:07:26Z-
dc.date.issued2008en_HK
dc.identifier.citationJournal Of Public Health, 2008, v. 30 n. 3, p. 282-292en_HK
dc.identifier.issn1741-3842en_HK
dc.identifier.urihttp://hdl.handle.net/10722/60278-
dc.description.abstractBackground: To estimate the proportion of and characterize women who had received cervical and breast screening and to quantify the associated preventable burden of disease and potential iatrogenic harm. Methods: A total of 3484 Hong Kong Chinese women were interviewed in person. Screening prevalence and associated predictors, disability-adjusted life-years (DALYs), the numbers of false-positive tests and the resultant confirmatory procedures and related complications were estimated. Results: A total of 6.2% of women (≥18) reported regular pap but no mammography or clinical breast examination (CBE) as per local evidence-based guidelines, whereas among women aged ≥40 years, 5.2% reported regular screening by all three modalities and 55.3% had never been screened for either cancer. Women who underwent regular health checkups were consistently the most likely to have been screened, as were younger, married and socially advantaged respondents. Triennial pap screening would save 708 DALYs annually, or 528 more DALYs compared with the status quo. However, this would generate 28 600 repeat smears and 390 colposcopies from false-positive screens. Opportunistic mammographic screening averted 100 DALYs currently, but could have potentially reduced a further 546 with biennial screening. Mass screening mammography (CBE) would lead to 33 700 (20 200) false-positives per year requiring 29 900 (8300) repeat mammograms or ultrasonograms, 6800 (3000) biopsies and 620 (270) biopsy-related complications. Conclusions: Screening uptake patterns are suboptimal. By making explicit the possible risks and benefits based on this template, policy makers in developing Asia with a similar female cancer burden may be able to use the information to make evidence-based decisions that are consistent with local circumstances, values and preferences. © The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://jpubhealth.oxfordjournals.org/en_HK
dc.relation.ispartofJournal of Public Healthen_HK
dc.rightsJournal of Public Health. Copyright © Oxford University Press.en_HK
dc.subjectBreast canceren_HK
dc.subjectCervical canceren_HK
dc.subjectDALYsen_HK
dc.subjectIatrogenesisen_HK
dc.subjectScreeningen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshBreast Neoplasms - diagnosis - prevention & controlen_HK
dc.subject.meshConfidence Intervalsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHealth Care Surveysen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIatrogenic Disease - epidemiologyen_HK
dc.subject.meshMass Screening - utilizationen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshOdds Ratioen_HK
dc.subject.meshUterine Cervical Neoplasms - diagnosis - prevention & controlen_HK
dc.titleWho receives, benefits from and is harmed by cervical and breast cancer screening among Hong Kong Chinese?en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1741-3842&volume=30&issue=3&spage=282&epage=292&date=2008&atitle=Who+receives,+benefits+from+and+is+harmed+by+cervical+and+breast+cancer+screening+among+Hong+Kong+Chinese?en_HK
dc.identifier.emailLeung, GM:gmleung@hku.hken_HK
dc.identifier.emailCowling, BJ:bcowling@hku.hken_HK
dc.identifier.emailCheung, ANY:anycheun@hkucc.hku.hken_HK
dc.identifier.emailNgan, HYS:hysngan@hkucc.hku.hken_HK
dc.identifier.emailLam, TH:hrmrlth@hkucc.hku.hken_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityCheung, ANY=rp00542en_HK
dc.identifier.authorityNgan, HYS=rp00346en_HK
dc.identifier.authorityLam, TH=rp00326en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/pubmed/fdn034en_HK
dc.identifier.pmid18482996en_HK
dc.identifier.scopuseid_2-s2.0-54249127357en_HK
dc.identifier.hkuros149198en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-54249127357&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume30en_HK
dc.identifier.issue3en_HK
dc.identifier.spage282en_HK
dc.identifier.epage292en_HK
dc.identifier.isiWOS:000259375100014-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.scopusauthoridWoo, PPS=8426498200en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridTsang, CSH=25522577900en_HK
dc.identifier.scopusauthoridCheung, ANY=54927484100en_HK
dc.identifier.scopusauthoridNgan, HYS=34571944100en_HK
dc.identifier.scopusauthoridGalbraith, K=36880414800en_HK
dc.identifier.scopusauthoridLam, TH=7202522876en_HK

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