scholarly journals Breast Cancer Mortality After Implementation of Organized Population-Based Breast Cancer Screening in Norway

2019 ◽  
Vol 112 (8) ◽  
pp. 839-846 ◽  
Author(s):  
Sofie Sebuødegård ◽  
Edoardo Botteri ◽  
Solveig Hofvind
Keyword(s):  
Breast Cancer ◽  
Screening Program ◽  
Evaluation Model ◽  
Breast Cancer Mortality ◽  
Population Based ◽  
Mammographic Screening ◽  
Similar Reduction ◽  
Individual Level ◽  
Parametric Survival Model ◽  
Model Counting

Abstract Background We estimated breast cancer (BC) mortality reduction associated with invitations to a nationwide population-based screening program and with changes in treatment. Materials and methods BreastScreen Norway started in 1996 and became nationwide in 2005. It invites women aged 50–69 years to biennial mammographic screening. We retrieved individual-level data for 1 340 333 women from national registries. During 1996–2014 (screening window), women contributed person-years in noninvited and invited periods. We created comparable periods for 1977–1995 (prescreening window) by dividing the follow-up time for each woman into pseudo-noninvited and pseudo-invited periods. We estimated BC mortality for the four periods, using the so-called evaluation model: counting BC deaths in each period for all women diagnosed within the period and counting BC deaths and person-years after screening-age for those diagnosed within screening age. We used a multivariable flexible parametric survival model to estimate hazard ratio (HR) for the effect of invitation and improved treatment. Results Using the regression approach, we found 5818 BC deaths across 16 533 281 person-years. Invitations to screening reduced BC mortality by 20% (HR = 0.80, 95% confidence interval [CI] = 0.70 to 0.91) among women 50 years and older and by 25% (HR = 0.75, 95% CI = 0.65 to 0.86) among screening-aged women. The treatment effect was 23% (HR = 0.77, 95% CI = 0.65 to 0.92) for women 50 years and older and 17% (HR = 0.83, 95% CI = 0.74 to 0.94) for screening-aged women. Conclusion We observed a similar reduction in BC mortality associated with invitations to screening and improvements in treatment during 1977–2014, among women 50 years and older.

scholarly journals Readmissions and complications in breast ductal carcinoma in situ: A retrospective study comparing screen- and non-screen-detected patients

2020 ◽  
Vol 16 ◽  
pp. 174550652096589
Author(s):  
Julieta Politi ◽  
María Sala ◽  
Laia Domingo ◽  
María Vernet-Tomas ◽  
Marta Román ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Confidence Interval ◽  
Ductal Carcinoma In Situ ◽  
Odds Ratio ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Screening Program ◽  
Population Based ◽  
Mammographic Screening

Objective: Population-wide mammographic screening programs aim to reduce breast cancer mortality. However, a broad view of the harms and benefits of these programs is necessary to favor informed decisions, especially in the earliest stages of the disease. Here, we compare the outcomes of patients diagnosed with breast ductal carcinoma in situ in participants and non-participants of a population-based mammographic screening program. Methods: A retrospective cohort study of all patients diagnosed with breast ductal carcinoma in situ between 2000 and 2010 within a single hospital. A total of 211 patients were included, and the median follow-up was 8.4 years. The effect of detection mode (screen-detected and non-screen-detected) on breast cancer recurrences, readmissions, and complications was evaluated through multivariate logistic regression analysis. Results: In the majority of women, breast ductal carcinoma in situ was screen-detected (63.5%). Screen-detected breast ductal carcinoma in situ was smaller in size compared to those non-screen-detected (57.53% < 20 mm versus 78.03%, p = 0.002). Overall, breast-conserving surgery was the most frequent surgery (86.26%); however, mastectomy was higher in non-screen-detected breast ductal carcinoma in situ (20.78% versus 9.7%, p = 0.024). Readmissions for mastectomy were more frequent in non-screen-detected breast ductal carcinoma in situ. Psychological complications, such as fatigue, anxiety, and depression, had a prevalence of 15% within our cohort. Risk of readmissions and complications was higher within the non-screen-detected group, as evidenced by an odds ratio = 6.25 (95% confidence interval = 1.95–19.99) for readmissions and an odds ratio = 2.41 (95% confidence interval = 1.95–4.86) for complications. Conclusions: Our findings indicate that women with breast ductal carcinoma in situ breast cancer diagnosed through population-based breast cancer screening program experience a lower risk of readmissions and complications than those diagnosed outside these programs. These findings can help aid women and health professionals make informed decisions regarding screening.

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

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.

scholarly journals The impact of breast density notification on rescreening rates within a population-based mammographic screening program

2022 ◽  
Vol 24 (1) ◽  
Author(s):  
Sarah Pirikahu ◽  
Helen Lund ◽  
Gemma Cadby ◽  
Elizabeth Wylie ◽  
Jennifer Stone
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Breast Density ◽  
Screening Program ◽  
Population Based ◽  
Mammographic Screening ◽  
Younger Women ◽  
Screening Programs ◽  
The Impact

Abstract Background High participation in mammographic screening is essential for its effectiveness to detect breast cancers early and thereby, improve breast cancer outcomes. Breast density is a strong predictor of breast cancer risk and significantly reduces the sensitivity of mammography to detect the disease. There are increasing mandates for routine breast density notification within mammographic screening programs. It is unknown if breast density notification impacts the likelihood of women returning to screening when next due (i.e. rescreening rates). This study investigates the association between breast density notification and rescreening rates using individual-level data from BreastScreen Western Australia (WA), a population-based mammographic screening program. Methods We examined 981,705 screening events from 311,656 women aged 40+ who attended BreastScreen WA between 2008 and 2017. Mixed effect logistic regression was used to investigate the association between rescreening and breast density notification status. Results Results were stratified by age (younger, targeted, older) and screening round (first, second, third+). Targeted women screening for the first time were more likely to return to screening if notified as having dense breasts (Percentunadjusted notified vs. not-notified: 57.8% vs. 56.1%; Padjusted = 0.016). Younger women were less likely to rescreen if notified, regardless of screening round (all P < 0.001). There was no association between notification and rescreening in older women (all P > 0.72). Conclusions Breast density notification does not deter women in the targeted age range from rescreening but could potentially deter younger women from rescreening. These results suggest that all breast density notification messaging should include information regarding the importance of regular mammographic screening to manage breast cancer risk, particularly for younger women. These results will directly inform BreastScreen programs in Australia as well as other population-based screening providers outside Australia who notify women about breast density or are considering implementing breast density notification.

Breast-cancer mortality in screened versus unscreened women: Long-term results from a population-based study in Queensland, Australia

2020 ◽  
pp. 096914132095077
Author(s):  
Nathan Dunn ◽  
Philippa Youl ◽  
Julie Moore ◽  
Hazel Harden ◽  
Euan Walpole ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Proportional Hazards ◽  
Breast Cancer Mortality ◽  
Population Based ◽  
Mammographic Screening ◽  
Cox Proportional Hazards ◽  
Long Term Results ◽  
Prior History ◽  
Population Based Study

Objective In the context of a mature mammographic screening programme, the aim of this population-based study was to estimate rates of breast-cancer mortality among participants versus non-participants in Queensland, Australia. Methods The Queensland Electoral Roll was used to identify women aged 50–65  in the year 2000 (n = 269,198). Women with a prior history of invasive or in situ breast cancer were excluded (n = 6,848). The study population was then linked to mammography records from BreastScreen Queensland together with the Wesley Breast Screening Clinic (the largest provider of private screening in Queensland) to establish a screened cohort (n = 187,558) and an unscreened cohort (n = 74,792). Cohort members were matched and linked to cancer notifications and deaths through the state-based Queensland Oncology Repository. Differences in breast-cancer mortality between the two cohorts were measured using Cox proportional hazards regression. Results After 16 years of follow-up, women in the screened cohort showed a 39% reduction in breast-cancer mortality compared to the unscreened cohort (HR = 0.61, 95%CI = 0.55–0.68). Cumulative mortality over the same period was 0.47% and 0.77% in the screened and unscreened cohorts, respectively. Conclusions This study found a significant reduction in breast-cancer mortality for women who participated in mammographic screening compared to unscreened women. Our findings of a breast-cancer mortality benefit for women who have mammographic screening are in line with other observational studies.

The Rationale and Current Controversies of Mammographic Screening for Breast Cancer

2002 ◽  
Vol 91 (3) ◽  
pp. 288-292 ◽  
Author(s):  
P. B. Dean
Keyword(s):  
Breast Cancer ◽  
Mammography Screening ◽  
Screening Program ◽  
Controlled Trial ◽  
Breast Cancer Mortality ◽  
Substantial Reduction ◽  
Mammographic Screening ◽  
Randomized Controlled ◽  
The Impact

The impact of mammography screening upon the chances of a woman dying from breast cancer has been studied for four decades. Until this century the results have always been presented in terms of benefit to populations, and have erroneously been assumed to be directly transferable to individual women. A multitude of factors combine to reduce the effect of screening upon a population as measurable in a randomized controlled trial. The most serious problem has been the misunderstanding that an invitation to mammography screening would be equivalent to actually getting a mammogram. Additionally, the control population also benefits from the screening program, and these benefits reduce the measurable effect of screening. Recent long-term trials, which have been able to fully document participation in mammography screening on an individual basis, have demonstrated an even more substantial reduction in breast cancer mortality attributable to mammography screening, with a much more limited impact of therapeutic advances against advanced breast cancer.

scholarly journals Effectiveness of the Korean National Cancer Screening Program in reducing breast cancer mortality

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Eunji Choi ◽  
Jae Kwan Jun ◽  
Mina Suh ◽  
Kyu-Won Jung ◽  
Boyoung Park ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Screening Program ◽  
Breast Cancer Mortality ◽  
Mammographic Screening ◽  
Incidence Rates ◽  
Primary Study ◽  
Cancer Screening Program ◽  
Mortality Rate Ratio ◽  
Central Cancer Registry

AbstractHigh incidences of breast cancer (BC) are reported in Asian women in their forties, and it is not clear whether mammographic screening reduces mortality among them. This study evaluated the effect of BC screening on mortality in Korea. We conducted a nationwide prospective cohort study of women invited to the Korean National Cancer Screening Program (KNCSP) between 2002 and 2003 (N = 8,300,682), with data linkage to the Korea Central Cancer Registry and death certificates through 2014 and 2015, respectively. Exposure to mammographic screening was defined using a modified never/ever approach. The primary study outcome was adjusted mortality rate ratio (MRR) for BC among screened and non-screened women estimated by Poisson regression. An adjusted MRR for all cause-death other than BC was examined to account for selection bias in the cohort. BC incidence rates for screened and non-screened women were 84.41 and 82.88 per 100,000 women-years, respectively. BC mortality rates for screened and non-screened women were 5.81 and 13.43 per 100,000 women-years, respectively, with an adjusted MRR for BC of 0.43 (95% CI, 0.41−0.44). The adjusted MRR for all-cause death excluding BC was 0.52 (95% CI, 0.52−0.52). The greatest reduction in BC mortality was noted for women aged 45−54 years, and there was no observable reduction in mortality after the age of 70 years. In conclusion, the KNCSP has been effective in reducing BC mortality among Korean women aged 40−69 years.

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