The incidence of fatal breast cancer measures the increased effectiveness of therapy in women participating in mammography screening

László Tabár, Peter B. Dean, Tony Hsiu Hsi Chen, Amy Ming Fang Yen, Sam Li Sheng Chen, Jean Ching Yuan Fann, Sherry Yueh Hsia Chiu, May Mei Sheng Ku, Wendy Yi Ying Wu, Chen Yang Hsu, Yu Ching Chen, Kerri Beckmann, Robert A. Smith, Stephen W. Duffy

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Women and their health care providers need a reliable answer to this important question: If a woman chooses to participate in regular mammography screening, then how much will this choice improve her chances of avoiding a death from breast cancer compared with women who choose not to participate?. Methods: To answer this question, we used comprehensive registries for population, screening history, breast cancer incidence, and disease-specific death data in a defined population in Dalarna County, Sweden. The annual incidence of breast cancer was calculated along with the annual incidence of breast cancers that were fatal within 10 and within 11 to 20 years of diagnosis among women aged 40 to 69 years who either did or did not participate in mammography screening during a 39-year period (1977-2015). For an additional comparison, corresponding data are presented from 19 years of the prescreening period (1958-1976). All patients received stage-specific therapy according to the latest national guidelines, irrespective of the mode of detection. Results: The benefit for women who chose to participate in an organized breast cancer screening program was a 60% lower risk of dying from breast cancer within 10 years after diagnosis (relative risk, 0.40; 95% confidence interval, 0.34-0.48) and a 47% lower risk of dying from breast cancer within 20 years after diagnosis (relative risk, 0.53; 95% confidence interval, 0.44-0.63) compared with the corresponding risks for nonparticipants. Conclusions: Although all patients with breast cancer stand to benefit from advances in breast cancer therapy, the current results demonstrate that women who have participated in mammography screening obtain a significantly greater benefit from the therapy available at the time of diagnosis than do those who have not participated.

Original languageEnglish
Pages (from-to)515-523
Number of pages9
JournalCancer
Volume125
Issue number4
DOIs
Publication statusPublished - Feb 15 2019

Fingerprint

Mammography
Breast Neoplasms
Incidence
Therapeutics
Confidence Intervals
Breast Diseases
Women's Health
Early Detection of Cancer
Sweden
Health Personnel
Population
Registries
History
Guidelines

Keywords

  • breast cancer
  • fatality
  • mammography
  • mortality
  • screening

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

The incidence of fatal breast cancer measures the increased effectiveness of therapy in women participating in mammography screening. / Tabár, László; Dean, Peter B.; Chen, Tony Hsiu Hsi; Yen, Amy Ming Fang; Chen, Sam Li Sheng; Fann, Jean Ching Yuan; Chiu, Sherry Yueh Hsia; Ku, May Mei Sheng; Wu, Wendy Yi Ying; Hsu, Chen Yang; Chen, Yu Ching; Beckmann, Kerri; Smith, Robert A.; Duffy, Stephen W.

In: Cancer, Vol. 125, No. 4, 15.02.2019, p. 515-523.

Research output: Contribution to journalArticle

Tabár, L, Dean, PB, Chen, THH, Yen, AMF, Chen, SLS, Fann, JCY, Chiu, SYH, Ku, MMS, Wu, WYY, Hsu, CY, Chen, YC, Beckmann, K, Smith, RA & Duffy, SW 2019, 'The incidence of fatal breast cancer measures the increased effectiveness of therapy in women participating in mammography screening', Cancer, vol. 125, no. 4, pp. 515-523. https://doi.org/10.1002/cncr.31840
Tabár, László ; Dean, Peter B. ; Chen, Tony Hsiu Hsi ; Yen, Amy Ming Fang ; Chen, Sam Li Sheng ; Fann, Jean Ching Yuan ; Chiu, Sherry Yueh Hsia ; Ku, May Mei Sheng ; Wu, Wendy Yi Ying ; Hsu, Chen Yang ; Chen, Yu Ching ; Beckmann, Kerri ; Smith, Robert A. ; Duffy, Stephen W. / The incidence of fatal breast cancer measures the increased effectiveness of therapy in women participating in mammography screening. In: Cancer. 2019 ; Vol. 125, No. 4. pp. 515-523.
@article{8c8464572ac445dfb0161f37ebcec0cb,
title = "The incidence of fatal breast cancer measures the increased effectiveness of therapy in women participating in mammography screening",
abstract = "Background: Women and their health care providers need a reliable answer to this important question: If a woman chooses to participate in regular mammography screening, then how much will this choice improve her chances of avoiding a death from breast cancer compared with women who choose not to participate?. Methods: To answer this question, we used comprehensive registries for population, screening history, breast cancer incidence, and disease-specific death data in a defined population in Dalarna County, Sweden. The annual incidence of breast cancer was calculated along with the annual incidence of breast cancers that were fatal within 10 and within 11 to 20 years of diagnosis among women aged 40 to 69 years who either did or did not participate in mammography screening during a 39-year period (1977-2015). For an additional comparison, corresponding data are presented from 19 years of the prescreening period (1958-1976). All patients received stage-specific therapy according to the latest national guidelines, irrespective of the mode of detection. Results: The benefit for women who chose to participate in an organized breast cancer screening program was a 60{\%} lower risk of dying from breast cancer within 10 years after diagnosis (relative risk, 0.40; 95{\%} confidence interval, 0.34-0.48) and a 47{\%} lower risk of dying from breast cancer within 20 years after diagnosis (relative risk, 0.53; 95{\%} confidence interval, 0.44-0.63) compared with the corresponding risks for nonparticipants. Conclusions: Although all patients with breast cancer stand to benefit from advances in breast cancer therapy, the current results demonstrate that women who have participated in mammography screening obtain a significantly greater benefit from the therapy available at the time of diagnosis than do those who have not participated.",
keywords = "breast cancer, fatality, mammography, mortality, screening",
author = "L{\'a}szl{\'o} Tab{\'a}r and Dean, {Peter B.} and Chen, {Tony Hsiu Hsi} and Yen, {Amy Ming Fang} and Chen, {Sam Li Sheng} and Fann, {Jean Ching Yuan} and Chiu, {Sherry Yueh Hsia} and Ku, {May Mei Sheng} and Wu, {Wendy Yi Ying} and Hsu, {Chen Yang} and Chen, {Yu Ching} and Kerri Beckmann and Smith, {Robert A.} and Duffy, {Stephen W.}",
year = "2019",
month = "2",
day = "15",
doi = "10.1002/cncr.31840",
language = "English",
volume = "125",
pages = "515--523",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "4",

}

TY - JOUR

T1 - The incidence of fatal breast cancer measures the increased effectiveness of therapy in women participating in mammography screening

AU - Tabár, László

AU - Dean, Peter B.

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 Mei Sheng

AU - Wu, Wendy Yi Ying

AU - Hsu, Chen Yang

AU - Chen, Yu Ching

AU - Beckmann, Kerri

AU - Smith, Robert A.

AU - Duffy, Stephen W.

PY - 2019/2/15

Y1 - 2019/2/15

N2 - Background: Women and their health care providers need a reliable answer to this important question: If a woman chooses to participate in regular mammography screening, then how much will this choice improve her chances of avoiding a death from breast cancer compared with women who choose not to participate?. Methods: To answer this question, we used comprehensive registries for population, screening history, breast cancer incidence, and disease-specific death data in a defined population in Dalarna County, Sweden. The annual incidence of breast cancer was calculated along with the annual incidence of breast cancers that were fatal within 10 and within 11 to 20 years of diagnosis among women aged 40 to 69 years who either did or did not participate in mammography screening during a 39-year period (1977-2015). For an additional comparison, corresponding data are presented from 19 years of the prescreening period (1958-1976). All patients received stage-specific therapy according to the latest national guidelines, irrespective of the mode of detection. Results: The benefit for women who chose to participate in an organized breast cancer screening program was a 60% lower risk of dying from breast cancer within 10 years after diagnosis (relative risk, 0.40; 95% confidence interval, 0.34-0.48) and a 47% lower risk of dying from breast cancer within 20 years after diagnosis (relative risk, 0.53; 95% confidence interval, 0.44-0.63) compared with the corresponding risks for nonparticipants. Conclusions: Although all patients with breast cancer stand to benefit from advances in breast cancer therapy, the current results demonstrate that women who have participated in mammography screening obtain a significantly greater benefit from the therapy available at the time of diagnosis than do those who have not participated.

AB - Background: Women and their health care providers need a reliable answer to this important question: If a woman chooses to participate in regular mammography screening, then how much will this choice improve her chances of avoiding a death from breast cancer compared with women who choose not to participate?. Methods: To answer this question, we used comprehensive registries for population, screening history, breast cancer incidence, and disease-specific death data in a defined population in Dalarna County, Sweden. The annual incidence of breast cancer was calculated along with the annual incidence of breast cancers that were fatal within 10 and within 11 to 20 years of diagnosis among women aged 40 to 69 years who either did or did not participate in mammography screening during a 39-year period (1977-2015). For an additional comparison, corresponding data are presented from 19 years of the prescreening period (1958-1976). All patients received stage-specific therapy according to the latest national guidelines, irrespective of the mode of detection. Results: The benefit for women who chose to participate in an organized breast cancer screening program was a 60% lower risk of dying from breast cancer within 10 years after diagnosis (relative risk, 0.40; 95% confidence interval, 0.34-0.48) and a 47% lower risk of dying from breast cancer within 20 years after diagnosis (relative risk, 0.53; 95% confidence interval, 0.44-0.63) compared with the corresponding risks for nonparticipants. Conclusions: Although all patients with breast cancer stand to benefit from advances in breast cancer therapy, the current results demonstrate that women who have participated in mammography screening obtain a significantly greater benefit from the therapy available at the time of diagnosis than do those who have not participated.

KW - breast cancer

KW - fatality

KW - mammography

KW - mortality

KW - screening

UR - http://www.scopus.com/inward/record.url?scp=85056150210&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056150210&partnerID=8YFLogxK

U2 - 10.1002/cncr.31840

DO - 10.1002/cncr.31840

M3 - Article

VL - 125

SP - 515

EP - 523

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 4

ER -