Effect of mammography screening on mortality by histological grade

Laszlo Tabar, Tony Hsiu Hsi Chen, Amy Ming Fang Yen, Sam Li Sheng Chen, Jean Ching Yuan Fann, Sherry Yueh Hsia Chiu, May M.S. Ku, Wendy Yi Ying Wu, Chen Yang Hsu, Yu Ying Chen, Kerri Beckmann, Robert A. Smith, Stephen W. Duffy

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3 Citations (Scopus)

Abstract

Background: It has been asserted that mammography screening preferentially benefits those with less aggressive cancers, with lesser or no impact on more rapidly progressing and therefore more life-threatening tumors. Methods: We utilized data from the Swedish Two-County Trial, which randomized 77,080 women ages 40 to 74 to invitation to screening and 55,985 for usual care. We tabulated cancers by histologic grade and then compared mortality from cancers specific to histologic grade between the invited and control group using Poisson regression, with specific interest in the effect on mortality from grade 3 cancers. We used incidence-based mortality from tumors diagnosed within the screening phase of the trial. Finally, we cross-tabulated grade with tumor size and node status, to assess downstaging within tumor grades. Results: There was a major reduction in mortality from grade 3 tumors (RR ¼ 0.65; 95% CI, 0.53–0.80; P < 0.001), and more deaths prevented from grade 3 tumors (n ¼ 95) than grade 1 and 2 tumors combined (n ¼ 48) in the invited group. The proportions of tumors 15 mm or larger and node-positive tumors were substantially reduced in the grade 3 tumors in the invited group. Conclusions: The combination of prevention of tumors progressing to grade 3 and detection at smaller sizes and lesser rates of lymph node metastases within grade 3 tumors results in a substantial number of deaths from grade 3 cancers being prevented by invitation to mammographic screening. Impact: Mammography screening prevents deaths from aggressive cancers. Cancer Epidemiol Biomarkers Prev; 27(2); 154–7. 2017 AACR.

Original languageEnglish
Pages (from-to)154-157
Number of pages4
JournalCancer Epidemiology Biomarkers and Prevention
Volume27
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

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Mammography
Mortality
Neoplasms
Tumor Biomarkers

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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Effect of mammography screening on mortality by histological grade. / Tabar, Laszlo; Chen, Tony Hsiu Hsi; Yen, Amy Ming Fang; Chen, Sam Li Sheng; Fann, Jean Ching Yuan; Chiu, Sherry Yueh Hsia; Ku, May M.S.; Wu, Wendy Yi Ying; Hsu, Chen Yang; Chen, Yu Ying; Beckmann, Kerri; Smith, Robert A.; Duffy, Stephen W.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 27, No. 2, 01.02.2018, p. 154-157.

Research output: Contribution to journalArticle

Tabar, L, Chen, THH, Yen, AMF, Chen, SLS, Fann, JCY, Chiu, SYH, Ku, MMS, Wu, WYY, Hsu, CY, Chen, YY, Beckmann, K, Smith, RA & Duffy, SW 2018, 'Effect of mammography screening on mortality by histological grade', Cancer Epidemiology Biomarkers and Prevention, vol. 27, no. 2, pp. 154-157. https://doi.org/10.1158/1055-9965.EPI-17-0487
Tabar, Laszlo ; Chen, Tony Hsiu Hsi ; Yen, Amy Ming Fang ; Chen, Sam Li Sheng ; Fann, Jean Ching Yuan ; Chiu, Sherry Yueh Hsia ; Ku, May M.S. ; Wu, Wendy Yi Ying ; Hsu, Chen Yang ; Chen, Yu Ying ; Beckmann, Kerri ; Smith, Robert A. ; Duffy, Stephen W. / Effect of mammography screening on mortality by histological grade. In: Cancer Epidemiology Biomarkers and Prevention. 2018 ; Vol. 27, No. 2. pp. 154-157.
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abstract = "Background: It has been asserted that mammography screening preferentially benefits those with less aggressive cancers, with lesser or no impact on more rapidly progressing and therefore more life-threatening tumors. Methods: We utilized data from the Swedish Two-County Trial, which randomized 77,080 women ages 40 to 74 to invitation to screening and 55,985 for usual care. We tabulated cancers by histologic grade and then compared mortality from cancers specific to histologic grade between the invited and control group using Poisson regression, with specific interest in the effect on mortality from grade 3 cancers. We used incidence-based mortality from tumors diagnosed within the screening phase of the trial. Finally, we cross-tabulated grade with tumor size and node status, to assess downstaging within tumor grades. Results: There was a major reduction in mortality from grade 3 tumors (RR ¼ 0.65; 95{\%} CI, 0.53–0.80; P < 0.001), and more deaths prevented from grade 3 tumors (n ¼ 95) than grade 1 and 2 tumors combined (n ¼ 48) in the invited group. The proportions of tumors 15 mm or larger and node-positive tumors were substantially reduced in the grade 3 tumors in the invited group. Conclusions: The combination of prevention of tumors progressing to grade 3 and detection at smaller sizes and lesser rates of lymph node metastases within grade 3 tumors results in a substantial number of deaths from grade 3 cancers being prevented by invitation to mammographic screening. Impact: Mammography screening prevents deaths from aggressive cancers. Cancer Epidemiol Biomarkers Prev; 27(2); 154–7. 2017 AACR.",
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T1 - Effect of mammography screening on mortality by histological grade

AU - Tabar, Laszlo

AU - Chen, Tony Hsiu Hsi

AU - Yen, Amy Ming Fang

AU - Chen, Sam Li Sheng

AU - Fann, Jean Ching Yuan

AU - Chiu, Sherry Yueh Hsia

AU - Ku, May M.S.

AU - Wu, Wendy Yi Ying

AU - Hsu, Chen Yang

AU - Chen, Yu Ying

AU - Beckmann, Kerri

AU - Smith, Robert A.

AU - Duffy, Stephen W.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: It has been asserted that mammography screening preferentially benefits those with less aggressive cancers, with lesser or no impact on more rapidly progressing and therefore more life-threatening tumors. Methods: We utilized data from the Swedish Two-County Trial, which randomized 77,080 women ages 40 to 74 to invitation to screening and 55,985 for usual care. We tabulated cancers by histologic grade and then compared mortality from cancers specific to histologic grade between the invited and control group using Poisson regression, with specific interest in the effect on mortality from grade 3 cancers. We used incidence-based mortality from tumors diagnosed within the screening phase of the trial. Finally, we cross-tabulated grade with tumor size and node status, to assess downstaging within tumor grades. Results: There was a major reduction in mortality from grade 3 tumors (RR ¼ 0.65; 95% CI, 0.53–0.80; P < 0.001), and more deaths prevented from grade 3 tumors (n ¼ 95) than grade 1 and 2 tumors combined (n ¼ 48) in the invited group. The proportions of tumors 15 mm or larger and node-positive tumors were substantially reduced in the grade 3 tumors in the invited group. Conclusions: The combination of prevention of tumors progressing to grade 3 and detection at smaller sizes and lesser rates of lymph node metastases within grade 3 tumors results in a substantial number of deaths from grade 3 cancers being prevented by invitation to mammographic screening. Impact: Mammography screening prevents deaths from aggressive cancers. Cancer Epidemiol Biomarkers Prev; 27(2); 154–7. 2017 AACR.

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