The Impact of the First 3 Years of Breast Cancer Screening on the Overall Presentation of Breast Cancer (original) (raw)
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Breast cancer in East Anglia: the impact of the breast screening programme on stage at diagnosis
Journal of medical screening, 1998
To assess the impact of the National Health Service breast screening programme on overall and stage-specific incidence of breast cancer in East Anglia; also, to predict the magnitude of the screening induced reduction in breast cancer mortality. Women resident in East Anglia aged 50-69, diagnosed between 1976 and 1995. Comparison of numbers and incidence of breast cancer by age, stage, and mode of detection; investigation of relative contributions of advanced (stages II, III, and IV) cancers to total incidence by detection mode; estimation of the reduction in advanced cancer incidence. There has been a large increase in early stage incidence in the age group 50-64 targeted by the screening programme. By 1995, the estimated decrease in advanced cancer incidence was between 7 and 19%. In 1995, of all breast cancers arising in the age group 50-69 years, 33% were screen detected, 27% were interval cancers, 15% were in non-attenders, 9% were in lapsed attenders, 7% occurred before invita...
BMJ, 2000
Objective To assess the impact of the NHS breast screening programme on mortality from breast cancer in women aged 55-69 years over the period 1990-8. Design Age cohort model with data for 1971-89 used to predict mortality for 1990-8 with assumption of no major effect from screening or improvements in treatment until after 1989. Effect of screening and other factors on mortality estimated by comparing three year moving averages of observed mortality with those predicted (by five year age groups from 50-54 to 75-79), the effect of screening being restricted to certain age groups. Setting England and Wales. Subjects Women aged 40 to 79 years. Results Compared with predicted mortality in the absence of screening or other effects the total reduction in mortality from breast cancer in 1998 in women aged 55-69 was estimated as 21.3%. Direct effect of screening was estimated as 6.4% (range of estimates from 5.4-11.8%). Effect of all other factors (improved treatment with tamoxifen and chemotherapy, and earlier presentation outside the screening programme) was estimated as 14.9% (range 12.2-14.9%). Conclusions By 1998 both screening and other factors, including improvements in treatment, had resulted in substantial reductions in mortality from breast cancer. Many deaths in the 1990s will be of women diagnosed in the 1980s and early 1990s, before invitation to screening. Further major effects from screening and treatment are expected, which together with cohort effects should result in further substantial reductions in mortality from breast cancer, particularly for women aged 55-69, over the next 10 years.
European Journal of Cancer, 1997
The purpose of this study was to compare results from the first screening round of two breast cancer screening programmes of similar design implemented in different health care settings. The East Anglian programme is part of the U.K. National Health Service Breast Screening Programme, which is a centralised programme with a limited number of dedicated screening units. The Bouches du RhGne programme is one of 13 French programmes based on a decentralised model using existing radiology clinics. Compliance and cancer detection rates were lower in the Bouches du Rhbne programme. Detection rates for small invasive cancers (< 10 mm) were similar in the two programmes, although larger cancers (320 mm) were detected in the Bouches du Rh6ne programme. Significantly, the shift towards more favourable distribution of prognostic characteristics associated with screen-detected breast cancers compared with those arising outside the programme is less marked in the Bouches du RhGne programme. This is probably due to the more favourable underlying disease status in the district resulting from a long history of breast awareness and spontaneous mammography.0 1997 Elsevier Science Ltd. All rights reserved.
Journal of medical screening, 2006
To analyse and compare the prognostic factors of breast cancer in the target population of our community-screening programme as a function of the method of detection and to analyse the differences in the prognostic factors as a function of the patient's age and the screening episode. A Breast Cancer-Screening Programme (BCSP) in Northeast Spain. Observational study of all primary malignant breast lesions diagnosed in a woman between 50 and 69 years of age between 18 October 1995 and 31 December 2002. The 16 centres that women from the target population might have attended were contacted. A total of 225 (37.2%) of the lesions included were diagnosed through the BCSP, 59 (9.7%) interval cancers were detected, and 321 (53.1%) were detected through other circuits. Node involvement was significantly lower in the lesions detected at screening (32%) in comparison to the interval cancers (41.8%) and those detected through other circuits (47.5%). A significantly larger percentage of the ...
British Journal of Cancer
Background: Population breast screening has been implemented in the UK for over 25 years, but the size of benefit attributable to such programmes remains controversial. We have conducted the first individual-based cohort evaluation of population breast screening in the UK, to estimate the impact of the NHS breast screening programme (NHSBSP) on breast cancer mortality. Methods: We followed 988 090 women aged 49-64 years in 1991 resident in England and Wales, who because of the staggered implementation of the NHSBSP, included both invited subjects and an uninvited control group. Individual-level breast screening histories were linked to individual-level mortality and breast cancer incidence data from national registers. Risk of death from breast cancer was investigated by incidence-based mortality analyses in relation to intention to screen and first round attendance. Overdiagnosis of breast cancer following a single screening round was also investigated. Results: Invitation to NHSBSP screening was associated with a reduction in breast cancer mortality in 1991-2005 of 21% (RR ¼ 0.79, 95% CI: 0.73-0.84, Po0 Á 001) after adjustment for age, socioeconomic status and lead-time. Breast cancer deaths among first invitation attenders were 46% lower than among non-attenders (RR ¼ 0.54, 95% CI: 0.51-0 Á 57, Po0.001) and 32% lower following adjustment for age, socioeconomic status and self-selection bias (RR ¼ 0.68, 95% CI: 0.63-0 Á 73, Po0.001). There was little evidence of overdiagnosis associated with invitation to first screen. Conclusions: The results indicate a substantial, statistically significant reduction in breast cancer mortality between 1991 and 2005 associated with NHSBSP activity. This is important in public health terms.
Breast cancer incidence related with a population-based screening programme
Medicina Clínica (english Edition), 2015
Objective: To compare breast cancer cumulative incidence, time evolution and stage at diagnosis between participants and non-participant women in a population-based screening programme. Methods: Cohort study of breast cancer incidence in relation to participation in a population screening programme. The study population included women from the target population of the screening programme. The source of information for diagnostics and stages was the population-based cancer registry. The analysis period was 1999-2010. Results: The relative risk for invasive, in situ, and total cancers diagnosed in participant women compared with non-participants were, respectively, 1.16 (0.94-1.43), 2.98 (1.16-7.62) and 1.22 (0.99-1.49). The relative risk for participants versus non-participants was 2.47 (1.55-3.96) for diagnosis at stage I, 2.58 (1.67-3.99) for T1 and 2.11 (1.38-3.23) for negative lymph node involvement. The cumulative incidence trend had two joint points in both arms, with an Annual
Journal of medical screening, 1997
To determine the pathological and biological characteristics of breast cancers diagnosed by screening and examined at the Edinburgh University pathology department. These cancers were classified by screening status: never screened (n = 111), prevalence screen detected (n = 105), and previously screened (n = 74). The last category arose in women who had been regularly screened during the trial; the cancers were diagnosed as interval cases before the first invitation to service screening (n = 33) or were incidence screen detected at that time (n = 41). Association (for operable invasive cancers, n = 250) of cancer characteristics with screening status reflects influences of biology (aggressiveness) or chronology (time of diagnosis), or both. The prognostic indicators tumour grade, histological type, and oestrogen receptor status were found in a smaller percentage of the patients with poor prognosis among the prevalence screen detected cases (9%, 77%, 18%) than among those previously s...
Journal of medical screening, 1996
To evaluate the impact of the prevalent round of the NHS breast screening programme on the whole population of women aged 50-64 during the period 1988-92, by comparing the numbers of cancers detected at screening with those diagnosed symptomatically, in one United Kingdom health region (population 3.5 million). To relate this impact to the achievement of national quality standards and the observed sensitivity and specificity of the programme. The breast screening programme computer systems and the Thames Cancer Registry database were used to diagnose cancers in women aged 50-64 during the period 1988-1992, who were classified into screen detected, interval cases, eligible but not yet invited, non-attenders, and those not registered with the programme. The programme met all national quality assurance targets for uptake, diagnostic process, and detection, but screen detected cases comprised only 48% of those diagnosed during 1991 and 1992 when the breast screening programme was fully ...