scholarly journals Thirteen years of breast screening had no measurable effect on breast cancer mortality in Norway

2012 ◽  
Vol 132 (7) ◽  
pp. 1725-1726 ◽  
Author(s):  
Karsten Juhl Jørgensen ◽  
John Brodersen ◽  
Peter C. Gøtzsche
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Breast Screening ◽  
Breast Cancer Mortality ◽  
Measurable Effect

Effect of population breast screening on breast cancer mortality to 2005 in England and Wales: A nested case-control study within a cohort of one million women

2017 ◽  
Vol 25 (2) ◽  
pp. 76-81 ◽  
Author(s):  
Louise E Johns ◽  
Anthony J Swerdlow ◽  
Susan M Moss
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Breast Screening ◽  
Best Practice ◽  
Cohort Analysis ◽  
Breast Cancer Mortality ◽  
Case Control ◽  
England And Wales ◽  
Nested Case Control ◽  
Control Study

Objectives To evaluate the effectiveness of the NHS breast screening programme (NHSBSP) on breast cancer mortality in England and Wales and to compare findings with a cohort analysis of the same underlying population. Methods A nested case-control study within a cohort of 959,738 women in England and Wales aged 49–64 who were eligible for routine NHSBSP screening during 1991–2005. Cases who died from breast cancer in 1991–2005 were matched to controls without breast cancer at the case diagnosis date and alive when the case died. Risk of breast cancer mortality associated with intention to screen (ITS) (7047 cases/28,188 controls) and screening attendance (4707 cases/9413 controls) was examined. Bias was minimised in accordance with currently advocated best practice. Odds ratios (ORs) were calculated using conditional logistic regression. Results were compared with findings from an incidence-based breast cancer mortality cohort analysis. Results ITS was associated with a 21% breast cancer mortality reduction (OR = 0.79, 95% confidence interval [CI]: 0.71–0.88, P < 0.001). Attendance ≤5 years before diagnosis was associated with a 47% reduction in breast cancer mortality after self-selection correction (OR = 0.53, 95% CI: 0.46–0.62, P < 0.001). Breast cancer mortality reduction associated with ITS was 21% in both the case-control and cohort analyses, but the impact of attendance was marginally greater in the case-control analysis (36% vs. 32%). Conclusions Case-control studies designed and analysed according to current best practice guidelines offer an effective means of evaluating population breast screening.

scholarly journals The Canadian National Breast Screening Study: Update on Breast Cancer Mortality

1997 ◽  
Vol 1997 (22) ◽  
pp. 37-41 ◽  
Author(s):  
Anthony B. Miller ◽  
Teresa To ◽  
Cornelia J. Baines ◽  
Claus Wall
Keyword(s):  
Breast Cancer ◽  
Cancer Mortality ◽  
Breast Screening ◽  
Breast Cancer Mortality ◽  
National Breast ◽  
Screening Study

scholarly journals Effectiveness of a small breast screening programme: 25 year evaluation (25 year breast screening evaluation)

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20180018
Author(s):  
Andrew Patric Nisbet ◽  
Andrew Borthwick-Clarke ◽  
Nic Scott ◽  
Helen Goulding ◽  
Harwood Jane
Keyword(s):  
Breast Cancer ◽  
Quality Control ◽  
Cancer Mortality ◽  
Breast Screening ◽  
Screening Programme ◽  
Breast Cancer Mortality ◽  
Interval Cancers ◽  
Breast Screening Programme ◽  
Small Breast ◽  
The Impact

Objective: To evaluate mammography screening quality on the Island of Jersey over a 25-year period from Jan 1990 to end March 2015 from females invited between ages 50 to 75 using a 2 yearly screening interval. Jersey had a population of only around 67,000 at onset, rising to around 100,000 at the end of the 25 years. Methods: An analysis was performed of key routinely collected measures that are important to determining if a screening programme is on course to reduce breast cancer mortality such as uptake, recall rates, screen detected cancer and interval cancer rates. Further supporting indicators including grade, stage and comparative deaths from breast cancer in screen detected and not screen detected females were also assessed. Results: Over the 25-year period 19,768 females were invited to screening and 16,866 attended, giving an uptake of 85.2%. There were 501 screen detected cancers of which 400 were invasive, and 101 DCIS. 125 interval cancers presented outside screening over the 25 years. The annual recall rate over the last 20 years was <6% for prevalent round and 4% for incident round screening. Based on the standardized detection ratio (SDR) and uptake, the estimated reduction in mortality from breast cancer was calculated as 40.2%. Conclusions: Recommended population sizes for breast units range from a quarter to half a million people. For very small units like Jersey serving smaller populations, rigorous quality control is essential to maintain credibility. Despite the small size of the programme evidence shows a similar detection rate to the UK NHS Breast screening programme was achieved. In small programmes careful monitoring of rates of uptake, recall, cancer detection and interval rates are required over adequate time periods together with supporting information to show that small units can achieve national standards and detection rates necessary to reduce breast cancer mortality. Advances in knowledge: Running a small breast cancer screening programme is challenging for quality control. The impact on mortality can be predicted for small screening programmes despite their size. 10-year group survival in screen detected invasive breast cancer >90%. Interval cancers are more advanced than screen detected invasive cancers, so high suspicion is still required in breast symptoms after "normal" screen result. Mortality in lapsed/ceased attenders suggest that extending age range could be beneficial.

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