Will screening mammography in the east do more harm than good?

Objectives. We sought to systematically review the evidence for population-based mammography as applied to a Chinese population. Methods. Primary reports for meta-analysis were identified by a search of MEDLINE and the Cochrane Library. Outcome measures included breast cancer-related mortality, the number needed to be screened to prevent 1 death, and the positive predictive value of mammography. Results. Pooled relative risk for breast cancer-related death in the screened group was 0.80 (95% confidence interval=0.71, 0.90). Applied to Hong Kong, this figure translates into a number needed to screen of 1302 healthy women screened annually for 10 years to prevent 1 death. Conclusions. Evidence is insufficient to justify population-based breast cancer screening by mammography for women in Hong Kong and other Asian populations with low breast cancer prevalence.