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

Stephen W. Duffy, László Tabár, Amy Ming Fang Yen, Peter B. Dean, Robert A. Smith, Håkan Jonsson, Sven Törnberg, Sam Li Sheng Chen, Sherry Yueh Hsia Chiu, Jean Ching Yuan Fann, May Mei Sheng Ku, Wendy Yi Ying Wu, Chen Yang Hsu, Yu Ching Chen, Gunilla Svane, Edward Azavedo, Helene Grundström, Per Sundén, Karin Leifland, Ewa FrodisJoakim Ramos, Birgitta Epstein, Anders Åkerlund, Ann Sundbom, Pál Bordás, Hans Wallin, Leena Starck, Annika Björkgren, Stina Carlson, Irma Fredriksson, Johan Ahlgren, Daniel Öhman, Lars Holmberg, Tony Hsiu Hsi Chen

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)2971-2979
Number of pages9
JournalCancer
Volume126
Issue number13
DOIs
Publication statusPublished - Jul 1 2020

Keywords

  • breast cancer
  • fatality
  • mammography
  • mortality
  • screening

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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