scholarly journals Repeated mammographic screening reduces breast cancer mortality along the continuum of age

2002 ◽  
Vol 9 (4) ◽  
pp. 163-167 ◽  
Author(s):  
M.J.M. Broeders ◽  
A.L.M. Verbeek ◽  
H. Straatman ◽  
P.G.M. Peer ◽  
P.C.M. Pasker-de Jong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Mortality ◽  
Screening Programme ◽  
Breast Cancer Mortality ◽  
Mammographic Screening ◽  
Protective Effects ◽  
Age Group ◽  
The Continuum

OBJECTIVE: The optimal age boundaries for breast cancer screening are still under debate. A case-referent design was used to describe the effect of mammographic screening on breast cancer mortality along the continuum of age, based on a 20 year follow up period. SETTING: The population based breast cancer screening programme in Nijmegen, The Netherlands, which has biennially invited women over 35 years since 1975. METHODS: Cases, defined as women who died from primary breast cancer between 1987 and 1997, were selected from the group of women who received at least one invitation to the screening programme. For 157 cases, 785 women from the same group were selected as referents. Information on the index screening (the screening examination preceding diagnosis of the case) was collected for both cases and referents. The risk of dying from breast cancer was calculated per 10 year moving age group for women who had attended the index screening versus those who had not. RESULTS: The youngest 10 year age group showing an effect in our study were women aged 45–54 at their index screening. Breast cancer mortality for women in this group who attended the index screening was 32% lower, although not significant, than for women who did not (odds ratio (OR) 0.68, 95% confidence interval (95% CI) 0.33 to 1.41). This reduction in risk was not explained solely by an effect in women over 50 because the OR in women aged 45–49 was 0.56 (95% CI 0.20 to 1.61). Reductions in mortality became smaller with increasing age. Nevertheless, for women over 60 at index screening, participation in screening over a maximum 4 year period before diagnosis of the case yielded protective effects at least up to an age around 80. CONCLUSIONS: Although our results are based on a relatively small number of cases, they suggest that even in a programme with a 2 year screening interval there may be a benefit of starting screening around age 45. Also older women who participate at least once every 4 years still have much to gain from screening.

scholarly journals Non-Participation in Breast Cancer Screening in Spain and Potential Application in the Present and Future: A Cross Sectional Study

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4331
Author(s):  
Juan José Muñoz-Sanz ◽  
María Jiménez-Palomares ◽  
Elisa María Garrido-Ardila ◽  
Juan Rodríguez-Mansilla
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Older Women ◽  
Breast Cancer Screening ◽  
Cancer Mortality ◽  
Screening Programme ◽  
Breast Cancer Mortality ◽  
Screening Methods ◽  
Cross Sectional ◽  
Screening Programs

Background: Currently, we are beginning to observe a stabilisation and even a decrease in breast cancer mortality in the world, which may be related, among other reasons, to breast cancer screening. Methods: The objective of this study was to analyse the different reasons why women do not participate in the Breast Cancer Early Detection Programme in Extremadura (Spain) and to discuss the results, offering possible tools to improve the screening programs. This is an observational, descriptive, cross-sectional and retrospective study. A questionnaire with 14 questions was carried out by telephone or mail. Results: A total of 3970 questionnaires were collected. However, only 2507 were valid. A total of 70.36% of young and educated women underwent mammographic controls. The type of women who did not attend the screening programme appointment corresponded to a woman of approximately 60 years of age, with no formal studies, married, with children, who does not work outside their home and who lived in the health area of Badajoz. Among the main reasons for not going to the appointment, 53.9% of the women surveyed indicated that they had check-ups with their gynaecologist, and this specialist referred them for a mammograph. These women were younger and have a higher level of education. Women with a lower educational level and older women did not have any mammography done and did not undergo screening. They indicated that they did not go to the appointment because they were afraid of having a mammography (44%) or because they did not receive the appointment in time (31.6%). A total of 26.9% of the women who did not attend the appointment for other reasons stated that they had problems in attending because they had a physical limitation (dependency). Conclusions: Women who did not participate in the breast cancer screening programme in Extremadura had low educational levels and were older women. Specifically, fear of having a mammogram was the main argument raised by these women. In addition, a small group stated that they did not consider mammography to be useful. At present and in the future, good quality screening programs must be carried out to contribute to the reduction in breast cancer mortality. Furthermore, enhancing the participation of women is essential to increase the attendance rate and, therefore, the success of the screening programmes.

scholarly journals Lower attendance rates in immigrant versus non-immigrant women in the Norwegian Breast Cancer Screening Programme

2017 ◽  
Vol 25 (3) ◽  
pp. 155-161 ◽  
Author(s):  
Sameer Bhargava ◽  
Kaitlyn Tsuruda ◽  
Kåre Moen ◽  
Ida Bukholm ◽  
Solveig Hofvind
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Screening Programme ◽  
Immigrant Women ◽  
Population Based ◽  
Mammographic Screening ◽  
Attendance Rates ◽  
Breast Cancer Screening Programme ◽  
Cancer Screening Programme

Objective The Norwegian Breast Cancer Screening Programme invites women aged 50–69 to biennial mammographic screening. Although 84% of invited women have attended at least once, attendance rates vary across the country. We investigated attendance rates among various immigrant groups compared with non-immigrants in the programme. Methods There were 4,053,691 invitations sent to 885,979 women between 1996 and 2015. Using individual level population-based data from the Cancer Registry and Statistics Norway, we examined percent attendance and calculated incidence rate ratios, comparing immigrants with non-immigrants, using Poisson regression, following women's first invitation to the programme and for ever having attended. Results Immigrant women had lower attendance rates than the rest of the population, both following the first invitation (53.1% versus 76.1%) and for ever having attended (66.9% versus 86.4%). Differences in attendance rates between non-immigrant and immigrant women were less pronounced, but still present, when adjusted for sociodemographic factors. We also identified differences in attendance between immigrant groups. Attendance increased with duration of residency in Norway. A subgroup analysis of migrants' daughters showed that 70.0% attended following the first invitation, while 82.3% had ever attended. Conclusions Immigrant women had lower breast cancer screening attendance rates. The rationale for immigrant women's non-attendance needs to be explored through further studies targeting women from various birth countries and regions.

scholarly journals Worldwide Review and Meta-Analysis of Cohort Studies Measuring the Effect of Mammography Screening Programmes on Incidence-Based Breast Cancer Mortality

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 976
Author(s):  
Amanda Dibden ◽  
Judith Offman ◽  
Stephen W. Duffy ◽  
Rhian Gabe
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Mortality ◽  
Mammography Screening ◽  
Meta Analysis ◽  
Breast Cancer Mortality ◽  
Substantial Reduction ◽  
Healthcare Setting ◽  
Actual Attendance

In 2012, the Euroscreen project published a review of incidence-based mortality evaluations of breast cancer screening programmes. In this paper, we update this review to October 2019 and expand its scope from Europe to worldwide. We carried out a systematic review of incidence-based mortality studies of breast cancer screening programmes, and a meta-analysis of the estimated effects of both invitation to screening and attendance at screening, with adjustment for self-selection bias, on incidence-based mortality from breast cancer. We found 27 valid studies. The results of the meta-analysis showed a significant 22% reduction in breast cancer mortality with invitation to screening, with a relative risk of 0.78 (95% CI 0.75–0.82), and a significant 33% reduction with actual attendance at screening (RR 0.67, 95% CI 0.61–0.75). Breast cancer screening in the routine healthcare setting continues to confer a substantial reduction in mortality from breast cancer.

Advanced Breast Cancer and Breast Cancer Mortality in Randomized Controlled Trials on Mammography Screening

2009 ◽  
Vol 27 (35) ◽  
pp. 5919-5923 ◽  
Author(s):  
Philippe Autier ◽  
Clarisse Héry ◽  
Jari Haukka ◽  
Mathieu Boniol ◽  
Graham Byrnes
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Advanced Breast Cancer ◽  
Breast Cancer Screening ◽  
Advanced Cancer ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Advanced Breast ◽  
Published Data ◽  
National Breast

Purpose We assessed changes in advanced cancer incidence and cancer mortality in eight randomized trials of breast cancer screening. Patients and Methods Depending on published data, advanced cancer was defined as cancer ≥ 20 mm in size (four trials), stage II+ (four trials), and ≥ one positive lymph node (one trial). For each trial, we obtained the estimated relative risk (RR) and 95% CI between the intervention and control groups, for both breast cancer mortality and diagnosis of advanced breast cancer. Using a meta-regression approach, log(RR-mortality) was regressed on log(RR-advanced cancer), weighting each trial by the reciprocal of the square of the standard error of log(RR) for mortality. Results RR for advanced breast cancer ranged from 0.69 (95% CI, 0.61 to 0.78) in the Swedish Two-County Trial to 0.97 (95% CI, 0.97 to 1.25) in the Canadian National Breast Screening Study-1 (NBSS-1) trial. Log(RR)s for advanced cancer were highly predictive of log(RR)s for mortality (R2 = 0.95; P < .0001), and the linear regression curve had a slope of 1.00 (95% CI, 0.76 to 1.25) after fixing the intercept to zero. The slope changed only slightly after excluding the Two-County Trial and the Canadian NBSS-1 and NBSS-2 trials. Conclusion In trials on breast cancer screening, for each unit decrease in incidence of advanced breast cancer, there was an equal decrease in breast cancer mortality. Monitoring of incidence of advanced breast cancer may provide information on the current impact of screening on breast cancer mortality in the general population.

Breast cancer screening for carriers of ATM, CHEK2, and PALB2 pathogenic variants: A comparative modeling analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10500-10500
Author(s):  
Kathryn P. Lowry ◽  
H. Amarens Geuzinge ◽  
Natasha K. Stout ◽  
Oguzhan Alagoz ◽  
John M. Hampton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Breast Cancer Incidence ◽  
Simulation Models ◽  
Pathogenic Variants ◽  
Life Years ◽  
Incidence And Mortality

10500 Background: Inherited pathogenic variants in ATM, CHEK2, and PALB2 confer moderate to high risks of breast cancer. The optimal approach to screening in these women has not been established. Methods: We used two simulation models from the Cancer Intervention and Surveillance Modeling Network (CISNET) and data from the Cancer Risk Estimates Related to Susceptibility consortium (CARRIERS) to project lifetime breast cancer incidence and mortality in ATM, CHEK2, and PALB2 carriers. We simulated screening with annual mammography from ages 40-74 alone and with annual magnetic resonance imaging (MRI) starting at ages 40, 35, 30, and 25. Joint and separate mammography and MRI screening performance was based on published literature. Lifetime outcomes per 1,000 women were reported as means and ranges across both models. Results: Estimated risk of breast cancer by age 80 was 22% (21-23%) for ATM, 28% (26-30%) for CHEK2, and 40% (38-42%) for PALB2. Screening with MRI and mammography reduced breast cancer mortality by 52-60% across variants (Table). Compared to no screening, starting MRI at age 30 increased life years (LY)/1000 women by 501 (478-523) in ATM, 620 (587-652) in CHEK2, and 1,025 (998-1,051) in PALB2. Starting MRI at age 25 versus 30 gained 9-12 LY/1000 women with 517-518 additional false positive screens and 197-198 benign biopsies. Conclusions: For women with ATM, CHEK2, and PALB2 pathogenic variants, breast cancer screening with MRI and mammography halves breast cancer mortality. These mortality benefits are similar to those for MRI screening for BRCA1/2 mutation carriers and should inform practice guidelines.[Table: see text]

scholarly journals Breast cancer screening in average-risk women: towards personalized screening

2019 ◽  
Vol 92 (1103) ◽  
pp. 20190660 ◽  
Author(s):  
Almir GV Bitencourt ◽  
Carolina Rossi Saccarelli ◽  
Christiane Kuhl ◽  
Elizabeth A Morris
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Task Force ◽  
Early Stage ◽  
Breast Cancer Mortality ◽  
Mammographic Screening ◽  
Screening Strategy ◽  
Average Risk ◽  
Early Stage Disease

Breast cancer screening is widely recognized for reducing breast cancer mortality. The objective in screening is to diagnose asymptomatic early stage disease, thereby improving treatment efficacy. Screening recommendations have been widely debated over the past years and controversies remain regarding the optimal screening frequency, age to start screening, and age to end screening. While there are no new trials, follow-up information of randomized controlled trials has become available. The American College of Physicians recently issued a new guidance statement on screening for breast cancer in average-risk women, with similar recommendations to the U.S. Preventive Services Task Force and to European guidelines. However, these guidelines differ from those ofother American specialty societies. The variations reflect differences in the organizations’ values, the metrics used to evaluate screening results, and the differences in healthcare organization (individualized or state-organized healthcare). False-positive rates and overdiagnosis of biologically insignificant cancer are perceived as the most important potential harms associated with mammographic screening; however, there is limited evidence on their actual consequences. Most specialty societies agree that physicians should offer mammographic screening at age 40 years for average-risk women and discuss its benefits and potential harms to achieve a personalized screening strategy through a shared decision-making process.

scholarly journals Breast cancer screening case–control study design: impact on breast cancer mortality

2011 ◽  
Vol 22 (4) ◽  
pp. 863-869 ◽  
Author(s):  
E. Paap ◽  
A.L.M. Verbeek ◽  
D. Puliti ◽  
E. Paci ◽  
M.J.M. Broeders
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Study Design ◽  
Cancer Mortality ◽  
Case Control Study ◽  
Breast Cancer Mortality ◽  
Case Control ◽  
Control Study

Effect of Issuing an Invitation for Breast Cancer Screening to Women Aged 65 to 69

1996 ◽  
Vol 3 (2) ◽  
pp. 88-89 ◽  
Author(s):  
P J Hendry ◽  
C Entwistle
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Detection ◽  
Screening Programme ◽  
Age Group ◽  
Breast Screening Programme ◽  
The United Kingdom ◽  
General Practices ◽  
National Health Service Breast

Objective –Breast cancer screening is available to all women over 50 in the United Kingdom on the National Health Service breast screening programme. Only women aged between 50 and 64 receive a written invitation, with women over 64 being expected to self refer. Unfortunately, despite the higher incidence of breast cancer in the older age group only a very small proportion of women over 64 attend for screening. The aim of the study was to test the hypothesis that women between the ages of 65 and 69 will attend for screening if invited. Method –Women aged 65 to 69 were invited for screening from general practices in the Inverness area and were treated in all respects as the usual screening age group. Results –An uptake of 76% was achieved with a cancer detection rate of 9.3 per thousand. Conclusion –These results lend weight to the suggestion that women in this age group should receive a specific invitation for breast cancer screening.

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