Advanced breast cancer rates in the epoch of service screening: The 400,000 women cohort study from Italy
| Autor: | Maria Michiara, Fabio Falcini, Adele Caldarella, Giovanni Maria Conti, Silvia Mancini, Marilena Manfredi, Paola Baldazzi, A C Finarelli, Stefania Caroli, N Collina, Susanna Baracco, L. Pizzi, G. Monticelli, P. Giorgi Rossi, P. Sgargi, Claudia Balducci, Rossella Negri, G. Miccinesi, Orietta Giuliani, Nicola Caranci, F Bozzani, Massimo Vicentini, Debora Canuti, Claudia Cirilli, Lauro Bucchi, Marco Zappa, Stefano Ferretti, Lucia Mangone, Gianfranco Manneschi, Eugenio Paci, Luigi Cataliotti, Carlo Naldoni, Enza Di Felice, Donella Puliti, Monica Serafini, C Petrucci, B Vitali, Alessandra Ravaioli, A. Pasquini, Priscilla Sassoli de Bianchi, Rosa Vattiato, Manuel Zorzi, M Zatelli, Cinzia Campari, Gianni Saguatti, Paolo Pandolfi |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty Mammography screening Cancer Research No-Show Patients Screening effectiveness Socio-culturale Screening attendance Breast Neoplasms Cohort Studies 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine medicine Mammography Humans Mass Screening 030212 general & internal medicine Mass screening Early Detection of Cancer Aged medicine.diagnostic_test Obstetrics business.industry Incidence (epidemiology) Incidence Self-selection bias Absolute risk reduction Cancer Middle Aged Patient Acceptance of Health Care medicine.disease Italy Socioeconomic Factors 030220 oncology & carcinogenesis Advanced breast cancer Cohort study Female Cohort business |
| Popis: | Background The objective of this study was to evaluate if mammography screening attendance is associated with a reduction in late-stage breast cancer incidence. Methods The cohort included over 400,000 Italian women who were first invited to participate in regional screening programmes during the 1990s and were followed for breast cancer incidence for 13 years. We obtained individual data on their exposure to screening and correlated this with total and stage-specific breast cancer incidence. Socio-economic status and pre-screening incidence data were used to assess the presence of self-selection bias. Results Overall, screening attendance was associated with a 10% excess risk of in situ and invasive breast cancer (IRR = 1.10; 95% confidence interval (CI): 1.06–1.14), which dropped to 5% for invasive cancers only (IRR = 1.05; 95% CI: 1.01–1.09). There were significant reductions among attenders for specific cancer stages; we observed a 39% reduction for T2 or larger (IRR = 0.61; 95% CI: 0.57–0.66), 19% for node positives (IRR = 0.81; 95% CI: 0.76–0.86) and 28% for stage II and higher (IRR = 0.72; 95% CI: 0.68–0.76). Our data suggest that the presence of self-selection bias is limited and, overall, invited women experienced a 17% reduction of advanced cancers compared with pre-screening rates. Conclusions Comparing attenders' and non-attenders' stage-specific breast cancer incidence, we have estimated that screening attendance is associated with a reduction of nearly 30% for stages II+. |
| Databáze: | OpenAIRE |
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