Effectiveness of population‐based service screening with mammography for women ages 40 to 49 years with a high or low risk of breast cancer: Socioeconomic status, parity, and age at birth of first child

Abstract

BACKGROUND: Invitation to mammography screening of women aged 40 to 49 years is a matter of debate in many countries and a cost-effective alternative in countries without screening among women aged 40 to 49 years could be inviting those at higher risk. The relative effectiveness of mammography screening was estimated for subgroups based on the breast cancer risk factors parity, age at time of birth of first child, and socioeconomic status (SES). METHODS: The SCReening of Young Women (SCRY) database consists of all women aged 40 to 49 years in Sweden between 1986 and 2005 and was split into a study and control group. The study group consisted of women residing in areas in which women aged 40 to 49 years were invited to screening and the control group of women in areas in which women aged 40 to 49 years were not invited to screening. Rate ratio (RR) estimates were calculated for 2 exposures: invitation and attendance. RESULTS: There were striking similarities noted in the RR pattern for women invited to and attending screening and no statistically significant difference or trend in the RR was noted by risk group. The RR estimates increased by increasing parity for parity of 0 to 2 and ranged from 0.55 (95% confidence interval [95% CI], 0.38-0.79) to 0.79 (95% CI, 0.65-0.95) for attending women. The RR for women with high SES was lower than that for women with low SES (RR, 0.72 [95% CI, 0.79 [95% CI,], respectively). For women aged 20 to 24 years at the time of the birth of their first child, the RR was 0.73 (95% CI, 0.58-0.91) and estimates for other ages were similar. CONCLUSIONS: There was no statistically significant difference noted in the relative effectiveness of mammography screening by parity, age at the time of birth of the first child, or SES. Cancer 2015;121:251-8.

Worldwide Review and Meta-Analysis of Cohort Studies Measuring the Effect of Mammography Screening Programmes on Incidence-Based Breast Cancer Mortality

“…Of these, four studies assessed the effectiveness of screening programmes outside Europe, one each from Canada [15] and the USA [16], and two from New Zealand [17,18]. The remaining 39 studies were European with twelve from Sweden [14,[19][20][21][22][23][24][25][26][27][28][29], nine from Finland [30][31][32][33][34][35][36][37][38], five from Norway [39][40][41][42][43], four from both Italy [44][45][46][47] and Denmark [48][49][50][51], two from the Netherlands [52,53] and the UK [54,55] and one from Spain [56]. There was overlap between some papers, whereby authors used the same data to estimate the effect of different outcomes or updated results with longer follow-up.…”

“…There was overlap between some papers, whereby authors used the same data to estimate the effect of different outcomes or updated results with longer follow-up. This resulted in sixteen exclusions (one paper from Denmark [51], four from Finland [31,34,35,37], two from Italy [44,46], three from Norway [39,42,43] and six from Sweden [19,21,22,26,27,29]). The remaining twenty-seven papers included in this review, representing independent populations, are summarized in Table 2.…”

Why the Gold Standard Approach by Mammography Demands Extension by Multiomics? Application of Liquid Biopsy miRNA Profiles to Breast Cancer Disease Management

“…Results demonstrated that false-positive results are common and are higher for annual screening, younger women, and women with dense breasts. It seems that the absolute benefits (e.g., number of deaths prevented) are smaller than for older women, because of general lower BC incidence and lower sensitivity of mammography in women aged 40-49 years [33,50].…”

The Role of Care Coordination in Meeting Quality Performance Measures in Ambulatory Care Settings

“…Despite known benefits, providers may be less likely to provide tobacco cessation to older adults; potential reasons for this include: time constraints, it is not considered part of their role as care provider, it is unfair to ask older people to quit smoking, it could cause damage to the patient doctor relationship, and it is inappropriate given patients' health status (Huddlestone et al, 2015 Services Task Force recommends women between 50 and 74 be screened (Nelson et al, 2016). The benefits of mammography screenings for women in their forties is debated (Hellquist et al, 2015 (Herlitz et al, 2010).…”