{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T22:37:31Z","timestamp":1769207851613,"version":"3.49.0"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Overdiagnosis estimates of ductal carcinoma in situ (DCIS) vary from 20\u201391%, which complicates screening communication and optimization. The aim was to quantify the influence of follow-up time and screening setting on overdiagnosis of DCIS. The fully validated micro-simulation Markov model for DCIS (SimDCIS) was used to estimate DCIS overdiagnosis in different screening settings with varying follow-up. DCIS overdiagnosis was defined as the number of diagnosed DCIS (screen-, clinically detected, or progressed to invasive breast cancer) in screening that would not have been diagnosed without screening. Outcomes were presented as overdiagnosed proportion and rate. The base cohort was screened biennially from age 50\u201374 with 76% compliance and 25 years (y) follow-up and compared to the non-screened cohort. Follow-up was varied from 2-25y, screening start 40-74y, screening interval 1-5y and compliance 50\u2013100%. DCIS overdiagnosis was estimated at 20% of all diagnosed DCIS and 38.1 overdiagnosed DCIS per 100,000 women screened biennially from age 50\u201374 at 76% compliance and 25y follow-up. The proportion of overdiagnosed DCIS increased with shorter follow-up (27% at 2y to 20% at 25y), older screening start age (1% at 40y to 15% at 74y), decreased screening interval (23% at 1y to 12% at 5y), and increased compliance (16% at half to 20% at full participation). In conclusion, reliable DCIS overdiagnosis estimates require attention to screening setting and \u226520 years follow-up. Older women (74y) showed up to seven times more overdiagnosis at initial screening than younger women (50y). Improved estimates can provide guidance in screening communication and optimization.<\/jats:p>","DOI":"10.1371\/journal.pone.0331821","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T18:42:03Z","timestamp":1769193723000},"page":"e0331821","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of follow-up, screening age, interval, and compliance on overdiagnosis of ductal carcinoma in situ (DCIS): A modelling study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8884-1936","authenticated-orcid":true,"given":"Keris","family":"Poelhekken","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel J.W.","family":"Greuter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique D.","family":"Dorrius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3104-4471","authenticated-orcid":true,"given":"Geertruida H.","family":"de Bock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"issue":"3","key":"pone.0331821.ref001","first-page":"209","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"pone.0331821.ref002","author":"B Lauby-Secretan","year":"2015"},{"issue":"2","key":"pone.0331821.ref003","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1148\/radiol.211839","article-title":"Ductal carcinoma in situ: state-of-the-art review","volume":"302","author":"LJ Grimm","year":"2022","journal-title":"Radiology"},{"issue":"4","key":"pone.0331821.ref004","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1038\/s41416-019-0478-6","article-title":"Ductal carcinoma in situ: to treat or not to treat, that is the question","volume":"121","author":"M van Seijen","year":"2019","journal-title":"Br J Cancer"},{"issue":"10445","key":"pone.0331821.ref005","doi-asserted-by":"crossref","first-page":"2734","DOI":"10.1016\/S0140-6736(24)00425-2","article-title":"Ductal carcinoma in situ of the breast: finding the balance between overtreatment and undertreatment","volume":"403","author":"S Delaloge","year":"2024","journal-title":"Lancet"},{"key":"pone.0331821.ref006","author":"European Commission. 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