Effect of organized mammography screening on breast cancer mortality: A population-based cohort study in Norway

To evaluate, by analysis of breast cancer mortality data from all the 26 Swedish counties for the years 1971 to 1990, whether the effect of the introduction of mammography screening in Sweden can be assessed by observation from existing mortality data. A Poisson regression model was used to study whether a decrease in breast cancer mortality among women aged 50–74 years was associated with the extent of mammography screening in different counties and periods. In regions where mammography screening had been introduced, breast cancer mortality tended to be decreased, on average, compared with regions with-'out screening. If a 10 year time lag between the start of screening and its full effect on mortality is assumed then the estimated reduction in breast cancer mortality associated with introduction of screening was 19% with a 95% confidence interval ranging from 3% to 37%. The results suggest that the effect of mammography screening may be studied using existing routine mortality data and appropriate statistical modelling. This way of assessing the outcome of the screening is valuable when continuously monitoring a screening programme that has become a public health routine.

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Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: a population based cohort study

Yearbook of Obstetrics Gynecology and Women s Health ◽

10.1016/s1090-798x(10)79374-7 ◽

2010 ◽

Vol 2010 ◽

pp. 292-294

Author(s):

J.S. Dungan

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Cancer Mortality ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Breast Cancer Mortality ◽

Population Based ◽

Serotonin Reuptake Inhibitors ◽

Selective Serotonin

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Reduction of breast cancer mortality associated with mammography screening: a modelling study using population-based data from 2 French départements

American Journal of Epidemiology ◽

10.1093/aje/kwaa218 ◽

2020 ◽

Author(s):

Arnaud Seigneurin ◽

Catherine Exbrayat ◽

Florence Molinié ◽

Lucie Croisier ◽

Florence Poncet ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Mortality ◽

Mammography Screening ◽

Treatment Effectiveness ◽

Breast Cancer Mortality ◽

Population Based ◽

Incidence Rates ◽

Micro Simulation ◽

Current Setting ◽

Meta Analyses

Abstract Meta-analyses of randomized controlled trials that started from 1963 to 1991 reported a decrease of breast cancer mortality associated with mammography screening. However, the effectiveness of population based screening programmes conducted nowadays may have changed, due to the better effectiveness of treatments for late stage cancers and the better diagnostic performance of mammography. The main objective of this study was to predict the reduction of breast cancer mortality associated with mammography screening in the French current setting. We compared breast cancer mortality in 2 simulated cohorts of women, which differed from each other solely by a 70% biennial participation in screening from 50 to 74 years old. The micro-simulation model used for predictions was calibrated with incidence rates of breast cancer by stage that were observed in Isère and Loire-Atlantique départements, France in 2007-2013. The model predicted a decrease of breast cancer mortality associated with mammography screening of 18% (95%CI: 5% - 31%) and 17% (95%CI: 3% - 29%), for models calibrated with data from Isère and Loire-Atlantique départements, respectively. Our results highlight the interest of biennial mammography screening from 50 to 74 years old to decrease breast cancer mortality in the current setting, despite improvement in treatment effectiveness.

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Impact of mammography screening programmes on breast cancer mortality in Switzerland, a country with different regional screening policies

BMJ Open ◽

10.1136/bmjopen-2017-017806 ◽

2018 ◽

Vol 8 (3) ◽

pp. e017806 ◽

Cited By ~ 5

Author(s):

Christian Herrmann ◽

Penelope Vounatsou ◽

Beat Thürlimann ◽

Nicole Probst-Hensch ◽

Christian Rothermundt ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Mortality ◽

Mammography Screening ◽

Breast Cancer Mortality ◽

Credible Interval ◽

Developed Countries ◽

Population Based ◽

Cancer Awareness ◽

Female Population ◽

Bayesian Hierarchical

IntroductionIn the past decades, mortality due to breast cancer has declined considerably in Switzerland and other developed countries. The reasons for this decline remain controversial as several factors occurred almost simultaneously, including important advances in treatment approaches, breast cancer awareness and the introduction of mammography screening programmes in many European countries. In Switzerland, mammography screening programmes (MSPs) have existed in some regions for over 20 years but do not yet exist in others. This offers the possibility to analyse its effects with modern spatiotemporal methodology. We aimed to assess the spatiotemporal patterns and the effect of MSPs on breast cancer mortality.SettingSwitzerland.ParticipantsThe study covers breast cancer deaths of the female population of Switzerland during the period 1969–2012. We retrieved data from the Swiss Federal Statistical Office aggregated on a small-area level.DesignWe fitted Bayesian hierarchical spatiotemporal models on death rates indirectly standardised by national references. We used linguistic region, degree of urbanisation, duration of population-based screening programmes and socioeconomic index as covariates.ResultsIn Switzerland, breast cancer mortality in women slightly increased until 1989–1992 and declined strongly thereafter. Until 2009–2012, the standardised mortality ratio declined to 57% (95% CI 54% to 60%) of the 1969–1972 value. None of the other coefficients of the spatial regressions had a significant effect on breast cancer mortality. In 2009–2012, no region had significantly elevated or reduced breast cancer mortality at 95% credible interval level compared with the national mean.ConclusionThere has been a strong reduction of breast cancer mortality from the 1990s onwards. No important spatial disparities were observed. The factors studied (urbanisation, language, duration of population-based MSP and socioeconomic characteristics) did not seem to have an influence on them. Low participation rates and opportunistic screening use may have contributed to the low impact of MSPs.

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Breast cancer screening program in Lithuania: trends in breast cancer mortality before and during the introduction of the mammography screening programme

Acta medica Lituanica ◽

10.15388/amed.2020.27.2.3 ◽

2020 ◽

Vol 28 (2) ◽

pp. 20-28

Author(s):

Laura Steponavičienė ◽

Rūta Briedienė ◽

Rasa Vansevičiūtė-Petkevičienė ◽

Daiva Gudavičienė ◽

Ieva Vincerževskienė

Keyword(s):

Breast Cancer ◽

Cancer Mortality ◽

Mammography Screening ◽

Screening Program ◽

Breast Cancer Mortality ◽

Target Population ◽

Population Based ◽

Cancer Awareness ◽

Cancer Screening Program ◽

Mammography Screening Program

BackgroundBreast cancer is the most frequent oncological disease as well as the leading cause of cancer death among women worldwide. Decline in mortality in economically strong countries is observed. This decline is mostly related to early diagnosis (improvement in breast cancer awareness and mammography screening program (MSP)) and more effective treatment. In the end of 2005, the MSP started in Lithuania. The main aim of this article was to evaluate breast cancer mortality during 22 years in Lithuania, as well as changes before the start of the MSP and during its implementation, in order to assess the influence of the MSP on mortality. Materials and MethodsAnalysis was based on data from the population-based Lithuanian Cancer Registry. Analysis of changes in mortality included the period from 1998 to 2019. Age standardized mortality rates were calculated for assessment of changes. Join-point regression analysis was used. ResultsApplying the segmental regression model, it was found that during the study period mortality was statistically significantly decreasing by -1.1% each year. Mortality among women under the age of 50 decreased both before and during the implementation of MSP. Mortality in the target population also was already decreasing until the implementation of the program, but since 2006 significant reduction in mortality was observed in this group. ConclusionsOverall breast cancer mortality is decreasing in Lithuania. After the implementation of MSP the largest reduction in mortality was observed among the target population, however, it is not as pronounced as it could be with the well-organized MSP.

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Excess Mortality from Breast Cancer in Relation to Mammography Screening in Northern Sweden

Journal of Medical Screening ◽

10.1177/096914139700400104 ◽

1997 ◽

Vol 4 (1) ◽

pp. 6-9 ◽

Cited By ~ 20

Author(s):

Per Lenner ◽

Håkan Jonsson

Keyword(s):

Breast Cancer ◽

Cancer Mortality ◽

Medical Records ◽

Mammography Screening ◽

Excess Mortality ◽

Breast Cancer Mortality ◽

Population Based ◽

Northern Sweden ◽

Future Studies ◽

Excess Number

Objectives— Previous randomised studies of mammography screening have shown a significant effect on breast cancer mortality, particularly in women aged 50–Q69 at randomisation. Breast cancer mortality has traditionally been studied by judgments on causes of death, either from cause of death registers or from medical records. In this study an alternative method was used, estimating the excess mortality associated with breast cancer. Setting— In 1990 two counties of northern Sweden started population based mammography screening of women aged 40–74. The unscreened population in the two other counties of the same region were selected as controls. Results— Excess mortality associated with breast cancer was lower in the screened population, and was discernible three to four years after the start of screening. The relative risk estimate, based on the cumulative excess number of deaths from breast cancer during 1990–95 in the screened versus the control population aged 40–74 (at diagnosis of breast cancer), was 0.72 (95% confidence interval (CI) 0.53 to 0.99). For women aged 50–69 it was 0.67 (95% CI 0.46 to 0.99). In the 50–69 age group the estimated excess number of deaths from breast cancer during 1995 was 17.0 per 100 000 women (95% CI 5.0 to 29.0) in the screened counties and 51.1 per 100 000 (95% CI 30.2 to 71.9) in the unscreened counties. Conclusions— Population based routine screening has substantial effects on breast cancer mortality in women aged 50–69. Estimation of excess mortality can be used in future studies to evaluate the effects of mammography screening on breast cancer mortality.

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