Association of Screening and Treatment With Breast Cancer Mortality by Molecular Subtype in US Women, 2000-2012

Plevritis, Sylvia K.; Muñoz, David F.; Kurian, Allison W.; Stout, Natasha K.; Alagöz, Oğuzhan; Near, Aimee M.; Lee, Sandra J.; Broek, Jeroen J. van den; Huang, Xuelin; Schechter, Clyde B.; Sprague, Brian L.; Song, Juhee; Koning, Harry J. de; Trentham‐Dietz, Amy; Ravesteyn, Nicolien T. van; Gangnon, Ronald E.; Chandler, Young; Li, Yisheng; Xu, Cong; Ergün, Meltem; Huang, Hui; Berry, Donald A.; Mandelblatt, Jeanne S.

doi:10.1001/jama.2017.19130

Cited by 229 publications

(207 citation statements)

References 35 publications

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“…This is in contrast to previous studies, which documented that racial disparities in survival were greatest for HR‐positive/luminal breast cancers . Triple‐negative breast cancers have a poorer prognosis compared with other subtypes, in part because this subtype is more likely to be diagnosed at an advanced stage, and the development of targeted therapies has lagged behind . Notably, a recent US population‐based study found that 4‐year relative survival was ≥95% for patients diagnosed with stage I disease across all breast cancer subtypes …”

Section: Selected Findingscontrasting

confidence: 68%

Breast cancer statistics, 2019

DeSantis

Gaudet

et al. 2019

CA A Cancer J Clinicians

2,466

1,881

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This article is the American Cancer Society’s biennial update on female breast cancer statistics in the United States, including data on incidence, mortality, survival, and screening. Over the most recent 5‐year period (2012‐2016), the breast cancer incidence rate increased slightly by 0.3% per year, largely because of rising rates of local stage and hormone receptor‐positive disease. In contrast, the breast cancer death rate continues to decline, dropping 40% from 1989 to 2017 and translating to 375,900 breast cancer deaths averted. Notably, the pace of the decline has slowed from an annual decrease of 1.9% during 1998 through 2011 to 1.3% during 2011 through 2017, largely driven by the trend in white women. Consequently, the black–white disparity in breast cancer mortality has remained stable since 2011 after widening over the past 3 decades. Nevertheless, the death rate remains 40% higher in blacks (28.4 vs 20.3 deaths per 100,000) despite a lower incidence rate (126.7 vs 130.8); this disparity is magnified among black women aged <50 years, who have a death rate double that of whites. In the most recent 5‐year period (2013‐2017), the death rate declined in Hispanics (2.1% per year), blacks (1.5%), whites (1.0%), and Asians/Pacific Islanders (0.8%) but was stable in American Indians/Alaska Natives. However, by state, breast cancer mortality rates are no longer declining in Nebraska overall; in Colorado and Wisconsin in black women; and in Nebraska, Texas, and Virginia in white women. Breast cancer was the leading cause of cancer death in women (surpassing lung cancer) in four Southern and two Midwestern states among blacks and in Utah among whites during 2016‐2017. Declines in breast cancer mortality could be accelerated by expanding access to high‐quality prevention, early detection, and treatment services to all women.

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Section: Selected Findingscontrasting

confidence: 68%

Breast cancer statistics, 2019

DeSantis

Gaudet

et al. 2019

CA A Cancer J Clinicians

2,466

1,881

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“…The continued decreases in death rates for female breast cancer, prostate cancer, and colorectal cancer largely reflect improved early detection and more effective treatments . Because mammography use has been stable since the early 2000s, the recent decrease in breast cancer death rates may largely reflect improvement in treatments, such as targeted therapies . The use of prostate‐specific antigen testing has substantially decreased following the US Preventive Services Task Force recommendations against routine testing for men aged 75 and older in 2008 and for all ages in 2012, which may have contributed to the less rapid decline in prostate cancer death rates during the most recent years compared with the previous period.…”

Section: Discussionmentioning

confidence: 99%

Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics

Cronin

Lake

Scott

et al. 2018

Cancer

1,142

676

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BACKGROUNDThe American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate to provide annual updates on cancer occurrence and trends in the United States.METHODSIncidence data were obtained from the CDC‐funded and NCI‐funded population‐based cancer registry programs and compiled by NAACCR. Data on cancer deaths were obtained from the National Center for Health Statistics National Vital Statistics System. Trends in age‐standardized incidence and death rates for all cancers combined and for the leading cancer types by sex, race, and ethnicity were estimated by joinpoint analysis and expressed as the annual percent change. Stage distribution and 5‐year survival by stage at diagnosis were calculated for breast cancer, colon and rectum (colorectal) cancer, lung and bronchus cancer, and melanoma of the skin.RESULTSOverall cancer incidence rates from 2008 to 2014 decreased by 2.2% per year among men but were stable among women. Overall cancer death rates from 1999 to 2015 decreased by 1.8% per year among men and by 1.4% per year among women. Among men, incidence rates during the most recent 5‐year period (2010‐2014) decreased for 7 of the 17 most common cancer types, and death rates (2011‐2015) decreased for 11 of the 18 most common types. Among women, incidence rates declined for 7 of the 18 most common cancers, and death rates declined for 14 of the 20 most common cancers. Death rates decreased for cancer sites, including lung and bronchus (men and women), colorectal (men and women), female breast, and prostate. Death rates increased for cancers of the liver (men and women); pancreas (men and women); brain and other nervous system (men and women); oral cavity and pharynx (men only); soft tissue, including heart (men only); nonmelanoma skin (men only); and uterus. Incidence and death rates were higher among men than among women for all racial and ethnic groups. For all cancer sites combined, black men and white women had the highest incidence rates compared with other racial groups, and black men and black women had the highest death rates compared with other racial groups. Non‐Hispanic men and women had higher incidence and mortality rates than those of Hispanic ethnicity. Five‐year survival for cases diagnosed from 2007 through 2013 ranged from 100% (stage I) to 26.5% (stage IV) for female breast cancer, from 88.1% (stage I) to 12.6% (stage IV) for colorectal cancer, from 55.1% (stage I) to 4.2% (stage IV) for lung and bronchus cancer, and from 99.5% (stage I) to 16% (stage IV) for melanoma of the skin. Among children, overall cancer incidence rates increased by 0.8% per year from 2010 to 2014, and overall cancer death rates decreased by 1.5% per year from 2011 to 2015.CONCLUSIONSFor all cancer sites combined, cancer incidence rates decreased among men but were stable among women. Overall, there continue to be significant declines in cancer death rates among both men and wo...

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“…Furthermore, the relative contribution of screening versus treatment will depend on the screening uptake rate, the sensitivity of the protocol, and access to state‐of‐the‐art treatment. Likewise, exercises in modeling based on estimation of the short‐term effect of screening using aggregate data, without being able to distinguish between individual women who are or are not screened, also cannot measure the true impact of screening . To date, no advance in therapy has been able to overcome the prognostic disadvantage of being diagnosed with a lymph node‐positive tumor.…”

Section: Discussionmentioning

confidence: 99%

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

Tabár

Dean

Chen

et al. 2018

Cancer

182

114

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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.

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Association of Screening and Treatment With Breast Cancer Mortality by Molecular Subtype in US Women, 2000-2012

Cited by 229 publications

References 35 publications

Breast cancer statistics, 2019

Breast cancer statistics, 2019

Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics

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

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