TY - JOUR
T1 - Is the incidence of advanced‐stage breast cancer affected by whether women attend a steady‐state screening program?
AU - de Munck, Linda
AU - Fracheboud, Jacques
AU - de Bock, Geertruida H.
AU - den Heeten, Gerard J.
AU - Siesling, Sabine
AU - Broeders, Mireille J.M.
N1 - Wiley deal
PY - 2018/8/15
Y1 - 2018/8/15
N2 - In this cross‐sectional population‐based study, we assessed the incidence of advanced breast cancer based on screening attendance. Women from the Netherlands Cancer Registry were included if aged ≥49 years and diagnosed with breast cancer between 2006 and 2011, and data were linked with the screening program. Cancers were defined as screen‐related (diagnosed <24 months after screening) or nonscreened (all other breast cancers). Two cut‐offs were used to define advanced breast cancer: TNM‐stage (III–IV vs 0–I–II) and T‐stage alone (≥15 mm vs <15 mm or DCIS). The incidence rates were adjusted for age and logistic regression was used to compare groups. Of the 72,612 included women diagnosed with breast cancer, 44,246 (61%) had screen‐related breast cancer. By TNM stage, advanced cancer was almost three times as likely to be at an advanced TNM stage in the nonscreened group compared with the screen‐related group (38 and 94 per 100,000, respectively; OR: 2.86, 95%CI: 2.72–3.00). By T‐stage, the incidence of advanced cancer was higher overall, and in nonscreened women was significantly higher than in screened women (210 and 169 per 100,000; OR: 1.85, 95%CI: 1.78–1.93). Data on actual screening attendance showed that the incidence of advanced breast cancer was significantly higher in nonscreened women than in screened women, supporting the expectation that screening would cause a stage shift to early detection. Despite critical evaluations of breast cancer screening programs, our data show that breast cancer screening is a valuable tool that can reduce the disease burden in women.
AB - In this cross‐sectional population‐based study, we assessed the incidence of advanced breast cancer based on screening attendance. Women from the Netherlands Cancer Registry were included if aged ≥49 years and diagnosed with breast cancer between 2006 and 2011, and data were linked with the screening program. Cancers were defined as screen‐related (diagnosed <24 months after screening) or nonscreened (all other breast cancers). Two cut‐offs were used to define advanced breast cancer: TNM‐stage (III–IV vs 0–I–II) and T‐stage alone (≥15 mm vs <15 mm or DCIS). The incidence rates were adjusted for age and logistic regression was used to compare groups. Of the 72,612 included women diagnosed with breast cancer, 44,246 (61%) had screen‐related breast cancer. By TNM stage, advanced cancer was almost three times as likely to be at an advanced TNM stage in the nonscreened group compared with the screen‐related group (38 and 94 per 100,000, respectively; OR: 2.86, 95%CI: 2.72–3.00). By T‐stage, the incidence of advanced cancer was higher overall, and in nonscreened women was significantly higher than in screened women (210 and 169 per 100,000; OR: 1.85, 95%CI: 1.78–1.93). Data on actual screening attendance showed that the incidence of advanced breast cancer was significantly higher in nonscreened women than in screened women, supporting the expectation that screening would cause a stage shift to early detection. Despite critical evaluations of breast cancer screening programs, our data show that breast cancer screening is a valuable tool that can reduce the disease burden in women.
KW - UT-Hybrid-D
KW - Breast cancer
KW - Mass screening
KW - Screen-detected
KW - Advanced-stage
KW - Incidence rate
KW - 22/4 OA procedure
U2 - 10.1002/ijc.31388
DO - 10.1002/ijc.31388
M3 - Article
SN - 0020-7136
VL - 143
SP - 842
EP - 850
JO - International journal of cancer
JF - International journal of cancer
IS - 4
ER -