A case-control study to evaluate the impact of the breast screening programme on mortality in England

Abstract

Background Over the past 30 years since the implementation of the National Health Service Breast Screening Programme, improvements in diagnostic techniques and treatments have led to the need for an up-to-date evaluation of its benefit on risk of death from breast cancer. An initial pilot case-control study in London indicated that attending mammography screening led to a mortality reduction of 39%. Methods Based on the same study protocol, an England-wide study was set up. Women aged 47–89 years who died of primary breast cancer in 2010 or 2011 were selected as cases (8288 cases). When possible, two controls were selected per case (15,202 controls) and were matched by date of birth and screening area. Results Conditional logistic regressions showed a 38% reduction in breast cancer mortality after correcting for self-selection bias (OR 0.62, 95% CI 0.56–0.69) for women being screened at least once. Secondary analyses by age group, and time between last screen and breast cancer diagnosis were also performed. Conclusions According to this England-wide case-control study, mammography screening still plays an important role in lowering the risk of dying from breast cancer. Women aged 65 or over see a stronger and longer lasting benefit of screening compared to younger women.

Research Trends in the Application of Artificial Intelligence in Oncology: A Bibliometric and Network Visualization Study

“…Moreover, the selection of patients and the riskbenefit trade-offs, even for established screening programs such as breast cancer, remain controversial. Indeed, it has been argued that a one-size-fits-all approach is at odds with the aim of personalized medicine [7][8][9]. Screening initiatives that are expanded without evidence-based indications can also be financially burdensome and waste valuable resources for budget-constrained health systems [10].…”

Breast Cancer Mortality in the Americas and Australasia over the Period 1980–2017 with Predictions for 2025

“…Obesity and lower physical activity are of considerable importance as well [ 1 ]. An adoption of early diagnosis and screening programs may have a role in incidence trends in low and middle HDI index countries, with consequent effects on mortality, since optimal implementation of early diagnosis and screening may lead to over a 30% reduction in breast cancer mortality [ 43 ]. Properly organized screening makes it possible to diagnose cancer at early stages and to initiate appropriate treatment, reducing women’s mortality from breast cancer.…”

A consensus approach: Understanding the support needs of women in Newport West, Wales, to participate in breast screening

“…Not all invited women will attend breast screening, while late‐stage breast cancer and increased breast cancer mortality have been found to be associated with failure to attend screening. 8 , 9 , 10 Breast screening‐related behaviour is very complex and has been explored widely in the United Kingdom and elsewhere. A wide range of factors have been identified, including personal (age, English speaking; ethnicity), socioeconomic (income; insurance), psychological (anxiety), cognitive (attitudes; beliefs; knowledge; intellectual capacity) and structural or organizational barriers.…”

“…Not all invited women will attend breast screening, while late‐stage breast cancer and increased breast cancer mortality have been found to be associated with failure to attend screening 8–10 . Breast screening‐related behaviour is very complex and has been explored widely in the United Kingdom and elsewhere.…”