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The assumption that screening identifies early cancers, thus preventing presentation with advanced disease, underlies the rationale for screening mammography. In a NEJM Perspective article, authors examined secular trends in incident metastatic breast and prostate cancer.
Although the incidence of breast cancer presenting as metastatic disease has remained stable since 1975, incidence of metastatic prostate cancer has declined by some 50% since 1988. Based on these data, the authors conclude that, while screening mammography has not identified (at an earlier stage) breast cancers destined to present as metastatic disease, it appears that prostate-specific antigen screening has effectively identified (at an earlier stage) prostate tumors dest…