Breast cancer mortality with varying invitational policies in organised mammography

Abstract

We examined the effect of different invitational policies on the reduction of breast cancer mortality at 60 -79 years of age within the Finnish mammography programme in 1992 -2003, which varied in its coverage at 60 -69 years of age. The data from 260 municipalities were grouped into three categories: regular invitations at 50 -59 years of age only, regular invitations at 50 -69 years of age, and regular invitations at 50 -59 years of age with irregular invitations at 60 -69 years of age. Observed deaths from breast cancer were compared to those expected without screening among all women and among the screened and non-screened women. Observed deaths were obtained from population data and from a cohort follow-up in 1992 -2003. Expected deaths were derived by modelling breast cancer mortality at population level in 1974 -1985 and 1992 -2003. The reduction in breast cancer mortality was strongest, 28% (0.72, 0.51 -0.97), in municipalities with regular invitations at 50 -69 years of age. No overall effect at 60 -79 years of age was observed with regular invitations at 50 -59 years of age. The study confirms a reduction by screening of breast cancer mortality in Finland. Uniform extension of invitations to 60 -69 years of age would increase the number of prevented breast cancer deaths among the elderly.

Breast Cancer Mortality in Mammographic Screening in Europe: A Review of Incidence-Based Mortality Studies

“…As Hakama et al 3 included most of the age group 50-69, we chose to include this study in the pooled estimate. Our best estimate of the breast cancer mortality reduction among women invited to screening, based on Hakama et al 3 Olsen et al 7 and our re-analysis of Sarkeala et al 8 was a combined RR estimate of 0.74 (95%CI 0.64 -0.87). In Hakama et al…”

“…3 the participation rate was 88% in the first round, in Sarkeala et al 8 the proportion of personyears among participants out of all person-years in the cohort screened at age 50-69 was 85%, whereas in Olsen et al 7 the participation rate in the first round was 71%. As women included in these three studies were followed for 6-11 years, this is a reliable estimate of the breast cancer mortality reduction after 6 -11 years of follow-up for women offered screening at age 50-69.…”

“…Three studies were from Sweden, 15,16,18 three from Finland 8,9,19 and one from Spain 17 ( Table 3). In this group, all RRs were statistically significant ranging from 0.52 to 0.82.…”

“…By design, the study by Sarkeala et al 8 belonged to group 3. However, when a comparison was made between women screened aged 50-69 with women screened at age 50-59 it was possible to include this study in group 2 as well.…”

Prioritizing multiple health behavior change research topics: expert opinions in behavior change science

“…If successful, the widespread adoption of healthy lifestyle is estimated to save over $16 billion in annual medical costs [16]. Further, prospective studies report strong and explicit evidence that characteristics of a healthy lifestyle increase longevity, including regular physical activity, cancer screening, non-smoking/cessation, low alcohol intake, a healthy diet, and normal body mass index (BMI) [17][18][19][20][21][22]. Moreover, adoption of as little as 3 healthy behaviors is estimated to reduce chronic disease by 68 to 71 % [19].…”