Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women.

Autor: Duffy SW; Centre for Cancer Prevention, Department of Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom., Tabár L; Department of Mammography, Falun Central Hospital, Falun, Sweden., Yen AM; School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan., Dean PB; Diagnostic Radiology, University of Turku, Turku, Finland., Smith RA; Cancer Control Sciences, American Cancer Society, Atlanta, Georgia., Jonsson H; Regional Cancer Center, Umeå University, Umeå, Sweden., Törnberg S; Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden., Chen SL; School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan., Chiu SY; Division of Biostatistics, Institute of Preventive Medicine, Chang Gung University, Taoyuan City, Taiwan., Fann JC; Department of Nutrition and Health Sciences, Kainan University, Taoyuan City, Taiwan., Ku MM; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan., Wu WY; Regional Cancer Center, Umeå University, Umeå, Sweden., Hsu CY; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan., Chen YC; Taipei City Hospital, Taipei City, Taiwan., Svane G; Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden., Azavedo E; Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden., Grundström H; Danderyd Hospital, Danderyd, Sweden., Sundén P; Danderyd Hospital, Danderyd, Sweden., Leifland K; Sankt Göran Hospital, Stockholm, Sweden., Frodis E; Västerås Central Hospital, Västerås, Sweden., Ramos J; Västerås Central Hospital, Västerås, Sweden., Epstein B; Orebro University Hospital, Orebro, Sweden., Åkerlund A; Central Hospital, Gavle, Sweden., Sundbom A; Karlstad Central Hospital, Karlstad, Sweden., Bordás P; Sunderby Hospital, Luleå, Sweden., Wallin H; Sundsvall Hospital, Sundsvall, Sweden., Starck L; Sundsvall Hospital, Sundsvall, Sweden., Björkgren A; Norrlands University Hospital, Umeå, Sweden., Carlson S; Norrlands University Hospital, Umeå, Sweden., Fredriksson I; Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden., Ahlgren J; Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden., Öhman D; Regional Cancer Center, Stockholm-Gotland, Stockholm, Sweden., Holmberg L; Uppsala University, Uppsala, Sweden., Chen TH; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2020 Jul 01; Vol. 126 (13), pp. 2971-2979. Date of Electronic Publication: 2020 May 11.
DOI: 10.1002/cncr.32859
Abstrakt: Background: It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death.
Methods: Among 549,091 women, covering approximately 30% of the Swedish screening-eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression.
Results: Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51-0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66-0.84 [P < .001]).
Conclusions: Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.
(© 2020 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.)
Databáze: MEDLINE
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