Summary

The Health Insurance Plan of Greater New York (HIP) Breast Cancer Screening Trial was a randomized screening study designed to test if breast cancer mortality rates could be reduced through the use of periodic screening. Periodic screening was composed of an initial examination followed by 3 subsequent annual exams. Screening consisted of a clinical breast examination and mammography. The study concluded that periodic screening resulted in a reduced breast cancer mortality rate. The effect appeared to be concentrated in participants over the age of 50.

Study Years: 1963-1986

Randomized trial with two arms:

• Arms
  • Arm I: Initial clinical breast examination and mammography followed by 3 annual screens.
  • Arm II: Control arm.

• Ages Eligible for Study: 40-64 Years
• Sexes Eligible for Study: Female
• Had to be enrolled in HIP for at least 1 year
• No prior breast cancer diagnosis

Enrollment

Enrollment: 60,695

• 30,565 in Control Arm
• 30,130 in Intervention Arm
  • 20,146 Screened
  • 9,984 Refused Sreening

Total Study Population Demographics (60,695 Randomized and Eligible People):

• Age (years):
  • Mean: 50.88
  • Range: 40-64
  • Median: 51

The Schema is a timeline of the study. It indicates start/end points, visits expected, major testing to be done, and any other information that is crucial to understanding how the study was completed.

Main Findings

Major analyses of the primary trial endpoints were conducted at the 5, 7, and 18 year intervals from randomization and found that screening reduced mortality that was largely seen in the participants over the age of 50.

• Proceedings: Changes in 5-year breast cancer mortality in a breast cancer screening program.
  Shapiro S, Strax P, Venet L, Venet W
  Proc Natl Cancer Conf. 1972; Volume 7: Pages 663-78 PUBMED
• Periodic screening for breast cancer: the HIP Randomized Controlled Trial. Health Insurance Plan.
  Shapiro S
  J. Natl. Cancer Inst. Monographs. 1997;: Pages 27-30 PUBMED
• Impact of efforts to increase participation in repetitive screenings for early breast cancer detection.
  Fink R, Shapiro S, Roester R
  Am J Public Health. 1972 Mar; Volume 62 (Issue 3): Pages 328-36 PUBMED
• Evidence on screening for breast cancer from a randomized trial.
  Shapiro S
  Cancer. 1977 Jun; Volume 39 (Issue 6 Suppl): Pages 2772-82 PUBMED
• The reluctant participant in a breast cancer screening program.
  Fink R, Shapiro S, Lewison J
  Public Health Rep. 1968 Jun; Volume 83 (Issue 6): Pages 479-90 PUBMED
• Periodic screening for breast cancer: the Health Insurance Plan Project, 1963 - 1986, and its sequelae.
  Shapiro S, Venet W, Strax P, Venet L.