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a on behalf of the EU-TOPIA consortium 1

Background: Populations differ with respect to their cancer risk and screening preferences, which may influence the performance of colorectal cancer (CRC) screening programs. This review aims to systematically compare the mortality effect of CRC screening across European regions. Methods: Six databases including Embase, Medline, Web of Science, PubMed publisher, Google Scholar and Cochrane Library were searched for relevant studies published before March 2018. Bibliographic searches were conducted to select studies assessing the effect of various screening tests (guaiac fecal occult blood test [gFOBT]; flexible sigmoidoscopy [FS]; fecal immunochemical test [FIT] and colonoscopy) on CRC mortality in Europe (PROSPERO protocol: CRD42016042433). Abstract reviewing, data extraction and risk of bias assessment were conducted independently by two reviewers. Results: A total of 18 studies were included; of which, 11 were related to gFOBT, 4 to FS, 2 to FIT and 1 to colonoscopy; 8 were randomised clinical trials, and 10, observational studies, and an approximately equal number of studies represented Northern, Western and Southern European regions. Among individuals invited to screening, CRC mortality reductions varied from 8% to 16% for gFOBT and from 21% to 30% for FS. When studies with a high risk of bias were considered, ranges were more extensive. The estimated effectiveness of gFOBT and FS screening appeared similar across different European regions.

Several single nucleotide polymorphisms (SNPs) affecting DNA repair capacity and modifying cancer susceptibility have been described. We evaluated the association of SNPs Arg194Trp, Arg280His, and Arg399Gln in the X-ray cross-complementing group 1 (XRCC1) and Thr241Met in the X-ray cross-complementing group 3 (XRCC3) DNA repair genes with the risk of brain tumors. The Caucasian study population consisted of 701 glioma (including 320 glioblastoma) cases, 524 meningioma cases, and 1,560 controls in a prospective population-based case-control study conducted in Denmark, Finland, Sweden, and the UK. The studied SNPs were not significantly associated with the risk of brain tumors. The highest odds ratios (ORs) for the associations were observed between the homozygous variant genotype XRCC1 Gln399Gln and the risk of glioma (OR = 1.32; 95% confidence interval, CI, 0.97-1.81), glioblastoma (OR = 1.48; 95% CI, 0.98-2.24), and meningioma (OR = 1.34; 95% CI, 0.96-1.86). However, in pair-wise comparisons a few SNP combinations were associated with the risk of brain tumors: Among others, carriers of both homozygous variant genotypes, i.e., XRCC1 Gln399Gln and XRCC3 Met241Met, were associated with a three-fold increased risk of glioma (OR = 3.18; 95% CI, 1.26-8.04) and meningioma (OR = 2.99; 95% CI, 1.16-7.72). In conclusion, no significant association with brain tumors was found for any of the polymorphisms, when examined one by one. Our results indicated possible associations between combinations of XRCC1 and XRCC3 SNPs and the risk of brain tumors.

Background: The aim of this study was to quantify the impact of organised mammography screening on breast cancer mortality across European regions. Therefore, a systematic review was performed including different types of studies from all European regions and stringently used clearly defined quality appraisal to summarise the best evidence. Methods: Six databases were searched including Embase, Medline and Web of Science from inception to March 2018. To identify all eligible studies which assessed the effect of organised screening on breast cancer mortality, two reviewers independently applied predefined inclusion and exclusion criteria. Original studies in English with a minimum follow-up of five years that were randomised controlled trials (RCTs) or observational studies were included. The Cochrane risk of bias instrument and the NewcastleeOttawa Scale were used to assess the risk of bias. Results: Of the 5015 references initially retrieved, 60 were included in the final analysis. Those comprised 36 cohort studies, 17 caseecontrol studies and 7 RCTs. None were from Eastern Europe. The quality of the included studies varied: Nineteen of these studies were of very good or good quality. Of those, the reduction in breast cancer mortality in attenders versus non-

Background: The aim of the current study was to examine impacts of the Finnish breast cancer (BC) screening programme on the population-based incidence and mortality rates. The programme has been historically targeted to a rather narrow age band, mainly women of ages 50-59 years.

We evaluated the effectiveness and the efficacy of populationbased mammography programme in Finland, and explored associations between the screening performance and the screening efficacy. The main outcome, incidence-based mortality from breast cancer, was estimated by invitation, participation, age at death, and screening centres categorised by recall rates. The study was based on an individual followup of screening invitees and participants from 1992 to 2003. The coverage of screening invitations was 95% among 50-59 years old women, and 20-40% among women aged 60-69 years. We compared observed deaths from breast cancer to expected breast cancer deaths without screening in ages 50-69 at death. The observed deaths were obtained from a cohort of individual invitees (n 5 361,848). The expected deaths were defined by modelling breast cancer mortality from 1974 to 1985 and 1992 to 2003 at population level. The population data were derived from the same municipalities (n 5 260) that were incorporated into the cohort. The breast cancer mortality among the invited women was reduced by 22% (relative risk 0.78, 95% confidence interval 0.70-0.87). After adjusting for the self-selection, the efficacy among the participants was 28% (0.72, 0.56-0.88). No clear association between the recall rates and the screening efficacy was observed. The organised mammography screening in Finland is effective. The relationship between the estimates of process and outcome of mammography is not yet straightforward: effectiveness and efficacy remain the best estimates for evaluating the success of mammography screening. ' 2007 Wiley-Liss, Inc.Key words: effectiveness; mammography; screening; breast cancer; epidemiology Several randomised trials have reported effectiveness of screening for breast cancer. The combined results showed 25% reduction in breast cancer mortality among women aged 50-69 years at randomisation. 1 The cohort studies on service screening from Sweden and Denmark have reported effects at similar level. [2][3][4] In Finland, a pilot study on breast cancer screening began in 1982. 5 The nationwide mammography programme started in 1987 and it was implemented gradually. The effectiveness for the first 5 years of the programme was analysed using randomised birth cohorts. 6 The study demonstrated a nonsignificant, 24% reduction in breast cancer mortality associated with invitation to screening.The adaptation of results from randomised trials to routine screening is not self-evident. The performance and validity of mammography screening within and between the European programmes have varied widely, 7-9 suggesting differences also in the effectiveness and adverse effects of screening. There has also been variation in the screening policies. 1 The effectiveness of mammography screening has been debated during the last years, 10-12 and the impact of population-based screening on breast cancer mortality has been analysed in many European countries. [2][3][4]6,[13][14][15] The main aim of the current study was to analyse the effectiv...

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